NPI | 1760262539 |
---|---|
Entity Type | Organization |
Authorized Contact | SHENITA STAGGERS Vice President 219-218-9906 |
Organization Subpart ? | No |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
Enumeration Date | 2023-09-29 |
Last Update Date | 2023-09-29 |