# LA PORTE CLINIC COMPANY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Knox Family Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770936965
- **Authorized official:** JENNIFER L JACKSON (SR DIRECTOR PROVIDER ENROLLMENT)
- **Authorized official phone:** (615) 465-3334

## Contact information

- **Practice address:** 104 E CULVER RD, SUITE 102, KNOX, IN 46534-2241
- **Practice address phone:** (219) 326-2461
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (615) 778-8071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/22/2016
- **Last updated:** 05/07/2024