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1356913578
ANDREW PORTLOCK
MERRILLVILLE, IN
NPI
1356913578
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2021-07-15
Last Update Date
2021-07-15
Business Address
ANDREW PORTLOCK
8555 TAFT ST
MERRILLVILLE, IN 46410-6123
Phone number: 219-769-4005
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Mailing Address
ANDREW PORTLOCK
8555 TAFT ST
MERRILLVILLE, IN 46410-6123
Phone number:
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