Organization
CALVARY ASSEMBLY OF GOD
Active
Other names
Connection Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CLARK (PRESIDENT)
(219) 987-4280
Entity
Organization
Contact information
Practice address
1317 15TH ST. SE, DEMOTTE, IN 46310-9393
(219) 987-4280
Mailing address
1317 15TH ST SE, DEMOTTE, IN 46310
(219) 987-4280
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
02/26/2021
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