| NPI | 1639364946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY BETH DOLEZAL-REYNOLDS Manager 219-872-2933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IN 05003416A) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |