Organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Active
Parent organization
ALLIED PHYSICIANS OF MICHIANA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALLIED PHYSICIANS OF MICHIANA, LLC
Authorized official
SHERY ROUSSARIE (CEO)
(574) 251-2100
Entity
Organization
Contact information
Practice address
6301 UNIVERSITY COMMONS, SUITE 430, SOUTH BEND, IN 46635-1571
(574) 968-2851
(574) 968-2855
Mailing address
6301 UNIVERSITY COMMONS, SUITE 230, SOUTH BEND, IN 46635-1571
(574) 251-2100
(574) 251-2151
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201048070A
—
IN
Enumeration date
09/12/2011
Last updated
03/17/2018
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