Individual
JACKIE A ROSARIO-PIRTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 E 86TH CT STE 205, MERRILLVILLE, IN 46410-6259
(219) 670-5438
Mailing address
1520 WALLACE ST, GARY, IN 46404-1865
(219) 670-5438
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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