Individual
EDGAR D PRATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 W 84TH DR STE 1, MERRILLVILLE, IN 46410-7013
(219) 756-4695
(219) 793-9629
Mailing address
501 W 84TH DRIVE, SUITE A, MERRILLVILLE, IN 46410
(219) 756-4695
(219) 793-9629
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000255A
IN
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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