Organization Name: | INCREMEDICAL LLC |
NPI Number: | 1225048945 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREG COOPER (MANAGING PARTNER) |
Mailing Address: | 1225 E Coolspring Ave Michigan City |
State: | IN US |
Postal Code: | 463606312 |
Phone Number: | 2198737037 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2006 |
NPI Last Update Date: | 11/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |