Organization
EARTHWORKS CENTER INC.
Active
Organization
EARTHWORKS CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARLENE M. CANTRELL R.P.T (PRESIDENT)
(219) 794-0029
Entity
Organization
Contact information
Practice address
7725 BROADWAY, SUITE A, MERRILLVILLE, IN 46410-4731
(219) 794-0029
(219) 794-0065
Mailing address
7725 BROADWAY, SUITE A, MERRILLVILLE, IN 46410
(219) 794-0029
(219) 794-0065
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
05001346A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197601
ATHEM
IN
01
—
90000962
BLUE CROSS OF ILLINOIS
IN
Enumeration date
11/08/2006
Last updated
03/23/2010
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