Organization
GREAT LAKES ORTHOPEDICS AND SPORTS MEDICINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH PITCHFORD DO (OWNER)
(219) 365-0220
Entity
Organization
Contact information
Practice address
1129 MERRILLVILLE RD, CROWN POINT, IN 46307-2710
(219) 661-8008
(219) 661-8998
Mailing address
9615 KEILMAN ST, SAINT JOHN, IN 46373-9406
(219) 661-8008
(219) 661-8998
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05004069A
IN
225100000X
Physical Therapist
Primary
05006551A
IN
225100000X
Physical Therapist
05007558A
IN
Other
Enumeration date
04/12/2007
Last updated
03/13/2017
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