Individual
MISS EMMA KRIVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
349 MEADOW LARK LN, LA PORTE, IN 46350-1951
(219) 262-4616
Mailing address
349 MEADOWLARK LANE, LAPORTE, IN 46350
(219) 262-4616
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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