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Individual

DALE POORTENGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
MIDWEST EXPRESS CLINIC, 31 SIBLEY ST STE A, HAMMOND, IN 46320
(219) 802-8800
Mailing address
MIDWEST EXPRESS CLINIC, 31 SIBLEY ST STE A, HAMMOND, IN 46320
(219) 802-8800

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71016085A
IN

Other

Enumeration date
12/10/2024
Last updated
12/10/2024
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