Individual
NICOLE KARIN THATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9950 CALUMET AVE, MUNSTER, IN 46321-4028
(219) 934-2840
Mailing address
9950 CALUMET AVE, MUNSTER, IN 46321-4028
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012282A
IN
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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