Organization
DIABETES ASSOCIATION OF ST JOSEPH COUNTY INC
Active
Organization
DIABETES ASSOCIATION OF ST JOSEPH COUNTY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONITA A RAINE PH.D. (EXECUTIVE DIRECTOR)
(574) 247-6047
Entity
Organization
Contact information
Practice address
6910 NORTH MAIN ST, BUILDING 9, GRANGER, IN 46530
(574) 247-6047
(574) 247-6060
Mailing address
6910 NORTH MAIN STREET, BLDG. 9, MAIL UNIT #10, GRANGER, IN 46530
(574) 247-6047
(547) 247-6060
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
28071850A
IN
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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