Organization
LAGRANGE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROON ANSARI-NAZ PHD (EXECUTIVE DIRECTOR/VICE PRESIDENT)
(517) 202-7174
Entity
Organization
Contact information
Practice address
2500 VENTURA WAY, LAGRANGE, IN 46761
(574) 296-6452
(574) 296-6484
Mailing address
500 ARCADE AVE STE 100, ELKHART, IN 46514-2478
(574) 296-6452
(574) 296-6484
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/07/2009
Last updated
04/07/2009
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