Individual
LARRY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
233 E 83, MERRILLVILLE, IN 46410
(773) 983-1185
Mailing address
233 E. 84TH DR. SUITE 205, MERRILLVILLE, IN 46410
(219) 240-4445
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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