| NPI | 1952566283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED SAEED IBRAHIM Owner 219-448-0667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IL 036096495) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05003890A) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2008-07-25 |