Organization
SPINE SPORTS & INDUSTRIAL REHABILITATION OF LIGONIER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA S IMBODY OT (OWNER)
(260) 894-9909
Entity
Organization
Contact information
Practice address
157 RIVER RD, LIGONIER, IN 46767-9537
(260) 894-9909
(260) 894-9913
Mailing address
8259 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 365-6560
(219) 365-6561
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/04/2007
Last updated
01/22/2009
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