| NPI | 1730389305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY TIOCO President 219-836-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2011-02-21 |