Organization
LA PORTE CLINIC COMPANY LLC
Active
Organization
LA PORTE CLINIC COMPANY LLC
Active
Other names
La Porte Physician Network Ophthalmology Care
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A SWAW (DIRECTOR)
(615) 778-8076
Entity
Organization
Contact information
Practice address
1300 STATE ST, SUITE 1B, LA PORTE, IN 46350-3185
(219) 362-6297
(219) 324-3061
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
IN
156F00000X
Technician/Technologist
—
IN
207W00000X
Ophthalmology Physician
—
IN
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IN
Other
Enumeration date
09/13/2016
Last updated
09/27/2016
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