| Ronald E Grow Inc | |
|
810 W Indiana Ave South Bend IN 46613-1828 | |
| (574) 289-5049 | |
| (574) 288-0840 |
| Full Name | Ronald E Grow Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 810 W Indiana Ave, South Bend, Indiana |
| Authorized Official Name and Position | Ronald E Grow (OWNER) |
| Authorized Official Contact | 5742895049 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald E Grow Inc 810 W Indiana Ave South Bend IN 46613-1828 Ph: (574) 289-5049 | Ronald E Grow Inc 810 W Indiana Ave South Bend IN 46613-1828 Ph: (574) 289-5049 |
| NPI Number | 1013117472 |
|---|---|
| Provider Enumeration Date | 07/23/2007 |
| Last Update Date | 07/23/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013117472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02000101A (Indiana) | Primary |
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