Organization
INDIANA SPORTS & MEDICAL SCIENCE INSTITUTE, PC
Active
Organization
INDIANA SPORTS & MEDICAL SCIENCE INSTITUTE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY JAMES MULLALY DO (OWNER)
(810) 814-2661
Entity
Organization
Contact information
Practice address
11275 DELAWARE PKWY STE A, CROWN POINT, IN 46307-7812
(219) 779-8735
(877) 715-2312
Mailing address
PO BOX 108, CROWN POINT, IN 46308-0108
(219) 662-5530
(219) 662-1365
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
02003099A
IN
Other
Enumeration date
08/12/2011
Last updated
07/11/2022
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