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Individual

MR. JACK J HUGHES III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
1850 W MATADOR ST, PERU, IN 46970-3711
(765) 689-5000
Mailing address
4476 N 622 W, HUNTINGTON, IN 46750-8984
(260) 358-8827

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
32002213A
IN

Other

Enumeration date
03/05/2013
Last updated
03/05/2013
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