Organization
FAMILY LIFE CLINIC, PC
Active
Other names
Family Life Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA BAKER (OFFICE MANAGER)
(219) 947-0797
Entity
Organization
Contact information
Practice address
111 W 10TH ST, SUITE 101, HOBART, IN 46342-5990
(219) 947-0797
(219) 942-6243
Mailing address
111 W 10TH ST, SUITE 101, HOBART, IN 46342-5990
(219) 947-0797
(219) 942-6243
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01050865A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200251650
—
IN
Enumeration date
07/29/2005
Last updated
09/20/2010
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