| NPI | 1891468278 |
|---|---|
| Other Name | THE SOUTH BEND CLINIC PORTAGE |
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN HILER Credentialing Coordinator 574-239-1567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2022-03-22 |