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1811208002
CASEY BODAK
MERRILLVILLE, IN
NPI
1811208002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2010-06-23
Last Update Date
2010-06-23
Business Address
-- CASEY BODAK
8555 TAFT ST
MERRILLVILLE, IN 46410-6123
Phone number: 219-769-4005
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Mailing Address
-- CASEY BODAK
8555 TAFT ST
MERRILLVILLE, IN 46410-6123
Phone number: 219-769-4005
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