Organization
DANIEL R. ROQUE PT, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL R. ROQUE P. T. (PRESIDENT)
(219) 670-5388
Entity
Organization
Contact information
Practice address
9209 MARIGOLD LANE, MUNSTER, IN 46321-3016
(219) 670-5388
Mailing address
9209 MARIGOLD LANE, MUNSTER, IN 46321-3016
(219) 670-5388
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200833270A
—
IN
05
—
200833280
—
IN
Enumeration date
05/04/2007
Last updated
05/27/2008
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