| |
333 W. 89th Avenue, Suite W4, Merriville, IN 46410-7050 | |
(219) 648-2041 | |
(219) 472-0665 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center |
Location | 333 W. 89th Avenue, Merriville, Indiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306307178 | NPI | - | NPPES |
300027182 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
333 W. 89th Avenue, Suite W4, Merriville, IN 46410-7050 Ph: (219) 648-2041 | 333 W. 89th Avenue, Suite W4, Merriville, IN 46410-7050 Ph: (219) 648-2041 |