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Individual

DR. GEORGE LARSEN KNELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
900 I ST, LAPORTE, IN 46350-5533
(219) 324-1700
(219) 324-1710
Mailing address
3245 HEALTH DRIVE, SUITE 100, GRANGER, IN 46530-3245
(574) 647-1840

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01036729A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100164530
IN
Enumeration date
11/02/2005
Last updated
10/06/2023
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