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Organization

ROLLING MEADOWS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JO BANEZ PT (REGISTERED PHYSICAL THERAPIST)
(765) 506-7373
Entity
Organization

Contact information

Practice address
604 RENNAKER ST., ROLLING MEADOWS HEALTH CARE CENTER, LAFONTAINE, IN 46940
(765) 981-2081
Mailing address
1810 W WESTLEA DR, MARION, IN 46952-2445

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05008821A
IN

Other

Enumeration date
05/23/2007
Last updated
08/22/2020
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