is a Health Service in Valparaiso, Indiana. practices all healthcare services and medical treatments related to Health Service. The NPI Number for is 1629235403. The last update date is .
's current location address is Po Box 1249, Valparaiso, Indiana. You can contact this provider via phone number 2194648115. The mailing address for is Po Box 1249, Valparaiso, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | Po Box 1249, Valparaiso, Indiana |
| Phone Number | 2194648115 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1629235403 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | Po Box 1249 |
|---|---|
| City | Valparaiso |
| State | Indiana (IN) |
| Post Code | 463841249 |
| Phone Number | 2194648115 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Health Service |
|---|---|
| Taxonomy | 261Qh0100X |
| Licence No | IN01028333 |
|
Definition: Provides general outpatient medical care by physicians and other providers. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 85652 | IN | BLUE CROSS PIN | |
| 84568 | IN | BLUE CROSS PIN |
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