LAWRENCE BREWERTON

DEMOTTE, IN
NPI1497972566
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy313M00000X Nursing Facility/Intermediate Care Facility
(Licence: IL  071005702)
Enumeration Date2007-04-19
Last Update Date2007-07-08
Business Address
-- LAWRENCE BREWERTON
10352 N 600 E
DEMOTTE, IN 46310-8959
Phone number: 219-345-5811
Mailing Address
-- LAWRENCE BREWERTON
8670 LANTERN DR
SAINT JOHN, IN 46373-9671
Phone number: 847-673-0718