Organization
TWIN RIVERS MEDICAL LABORATORY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONNIE LOUELLEN BOSTIC RMT (PRESIDENT)
(574) 739-0004
Entity
Organization
Contact information
Practice address
902 W. BROADWAY, LOGANSPORT, IN 46947-2978
(574) 739-0004
(574) 739-0105
Mailing address
902 W. BROADWAY, LOGANSPORT, IN 46947-2978
(574) 739-0004
(574) 739-0105
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
IN
Other
Enumeration date
06/21/2005
Last updated
08/27/2007
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