| NPI | 1538611587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA JEAN DUTTLINGER Owner 219-688-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: IN 05010628A) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |