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Organization

SELF-ISH RX

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DANNON RAE MARTIN WALKER PA-C (OWNER/AUTHORIZED OFFICIAL)
(219) 877-9353
Entity
Organization

Contact information

Practice address
219 E 9TH ST, MICHIGAN CITY, IN 46360-3523
(219) 877-9353
Mailing address
5475 BROADWAY UNIT A300, MERRILLVILLE, IN 46410-1647
(219) 877-9353

Taxonomy

Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary

Other

Enumeration date
01/24/2026
Last updated
01/24/2026
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