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Organization

LIVING WATER WELLNESS AND THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES ARIAN KIRKLAND P.T., D.P.T., D.M.T. (OWNER)
(248) 210-8805
Entity
Organization

Contact information

Practice address
6643 LAGOON WAY, APARTMENT 4, PORTAGE, IN 46368-4277
(248) 210-8805
Mailing address
7895 BROADWAY STE D, MERRILLVILLE, IN 46410-5529
(213) 200-2163

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
261QP2000X
Physical Therapy Clinic/Center
Primary
05010477A
IN

Other

Enumeration date
11/17/2012
Last updated
02/20/2025
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