Organization
INCREMEDICAL LLC
Active
Other names
LEAP Rehabilitation & Sports
Organization subpart
No
Provider details
NPI number
Authorized official
GREG COOPER (MANAGING PARTNER)
(219) 365-6560
Entity
Organization
Contact information
Practice address
1225 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6312
(219) 873-7037
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-6561
(219) 365-6561
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200494630A
—
IN
Enumeration date
08/08/2006
Last updated
11/04/2009
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