| Na | |
|
18 W Shakespeare Dr Valparaiso IN 46385-7979 | |
| (163) 029-1028 | |
| Not Available |
| Full Name | Na |
|---|---|
| Speciality | Clinic/center |
| Location | 18 W Shakespeare Dr, Valparaiso, Indiana |
| Authorized Official Name and Position | Jenna Toennies (CEO/ OCCUPATIONAL THERAPIST) |
| Authorized Official Contact | 6302910282 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Na 18 W Shakespeare Dr Valparaiso IN 46385-7979 Ph: (163) 029-1028 | Na 18 W Shakespeare Dr Valparaiso IN 46385-7979 Ph: (163) 029-1028 |
| NPI Number | 1366190043 |
|---|---|
| Provider Enumeration Date | 03/12/2022 |
| Last Update Date | 03/12/2022 |
| Certification Date | 03/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366190043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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