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50740 Princess Way Suite 600 Granger IN 46530-4339 | |
(574) 243-8600 | |
(574) 243-8601 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 50740 Princess Way, Granger, Indiana |
Authorized Official Name and Position | Julie M. Ortega-schmitt (OWNER) |
Authorized Official Contact | 5742438600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 540 Granger IN 46530-0540 Ph: (574) 243-8600 | 50740 Princess Way Suite 600 Granger IN 46530-4339 Ph: (574) 243-8600 |
NPI Number | 1295903748 |
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Provider Enumeration Date | 02/19/2008 |
Last Update Date | 06/30/2011 |
Identifier | Type | State | Issuer |
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1295903748 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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