Individual
MADONNA L GRABOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1265 S LAKE PARK AVE, SUITE D, HOBART, IN 46342-5961
(219) 945-1538
(219) 945-0151
Mailing address
1265 S LAKE PARK AVE, SUITE D, HOBART, IN 46342-5961
(219) 945-1538
(219) 945-0151
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001448A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000306881
ANTHEM
IN
01
—
05001448A
BCBS OF IL
IL
05
—
200467670
—
IN
Enumeration date
08/22/2006
Last updated
04/13/2012
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