| NPI | 1801123583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINE S BERGERON President 219-756-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |