| |
20 N 3rd St Lafayette IN 47901-1205 | |
(812) 249-6316 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 20 N 3rd St, Lafayette, Indiana |
Authorized Official Name and Position | Jan Hopkins (ASSOC. OPS MGR) |
Authorized Official Contact | 8645010751 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | 20 N 3rd St Lafayette IN 47901-1205 Ph: (812) 249-6316 |
NPI Number | 1821535287 |
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Provider Enumeration Date | 01/24/2017 |
Last Update Date | 03/25/2022 |
Identifier | Type | State | Issuer |
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1821535287 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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