Individual
REGINA MAURICE ETIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPECIMEN COLLECTOR
Contact information
Practice address
8300 BROADWAY STE A1, MERRILLVILLE, IN 46410-6285
(779) 236-7071
Mailing address
1855 W 84TH DR APT G181, MERRILLVILLE, IN 46410-8424
(779) 236-7071
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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