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2801 Bertholet Blvd Ste 201 Valparaiso IN 46383-7959 | |
| (844) 458-2800 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2801 Bertholet Blvd Ste 201, Valparaiso, 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 |
|---|---|
124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | 2801 Bertholet Blvd Ste 201 Valparaiso IN 46383-7959 Ph: (844) 458-2800 |
| NPI Number | 1689127474 |
|---|---|
| Provider Enumeration Date | 07/27/2016 |
| Last Update Date | 03/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689127474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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