Memorial Health System, INC.
Physical Therapist in La Porte, IN. Organization (NPI-2).
NPI number1013133487
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1013133487
- Entity type
- Organization (NPI-2)
- Legal business name
- Memorial Health System, INC.
- Organization subpart
- No
- Enumeration date
- Apr 17, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Other names
- Laporte Pt (Other Name)
Practice location
900 I StLa Porte, IN 46350-5533
Phone 219-324-1700
Mailing address
328 N Michigan StSuite 200
South Bend, IN 46601-1244
Phone 574-647-1069
Authorized official
Jeffrey Costello
Vp-Cfo
5746473549
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