Individual
RENETTA STALLING KNIGHTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 W 15TH AVE, GARY, IN 46404-1963
(219) 951-0531
Mailing address
2207 ROOSEVELT PL, GARY, IN 46404-3335
(219) 484-5523
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
IN
Other
Enumeration date
11/16/2024
Last updated
11/16/2024
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