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Organization
REDIMED DEKALB LLC
Active
Organization
REDIMED DEKALB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE T BREWER (DIRECTOR OF ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
253 N GRANDSTAFF DR, AUBURN, IN 46706-1668
(260) 925-9511
Mailing address
253 N GRANDSTAFF DR, AUBURN, IN 46706-1668
(260) 925-9511
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
06/17/2006
Last updated
04/29/2009
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