| 360 Integrated Medical Center, Pc | |
|
2504 Monroe St La Porte IN 46350-5241 | |
| (219) 326-5100 | |
| (219) 326-0180 |
| Full Name | 360 Integrated Medical Center, Pc |
|---|---|
| Speciality | General Practice |
| Location | 2504 Monroe St, La Porte, Indiana |
| Authorized Official Name and Position | Matthew Kirkham (OWNER) |
| Authorized Official Contact | 2193265100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 360 Integrated Medical Center, Pc 2504 Monroe St La Porte IN 46350-5241 Ph: () - | 360 Integrated Medical Center, Pc 2504 Monroe St La Porte IN 46350-5241 Ph: (219) 326-5100 |
| NPI Number | 1710459458 |
|---|---|
| Provider Enumeration Date | 12/19/2018 |
| Last Update Date | 12/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710459458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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