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1427663418
BENEDICT IANE ROQUE LUSUNG
VALPARAISO, IN
NPI
1427663418
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IN 05013907A)
Enumeration Date
2020-09-15
Last Update Date
2020-11-10
Business Address
BENEDICT IANE ROQUE LUSUNG
1200 ROOSEVELT PL UNIT A
VALPARAISO, IN 46383-3707
Phone number: 219-548-4663
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Mailing Address
BENEDICT IANE ROQUE LUSUNG
1200 ROOSEVELT PL UNIT A
VALPARAISO, IN 46383-3707
Phone number: 219-548-4663
Copy
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