Individual
MR. RODERICK BERTRAM EWING SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3412 DEODAR ST, EAST CHICAGO, IN 46312-2024
(219) 381-7235
Mailing address
3412 DEODAR ST, EAST CHICAGO, IN 46312-2024
(219) 381-7235
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
0410-21-5033
IN
Other
Enumeration date
07/27/2011
Last updated
07/27/2011
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