Individual
JUSTIN LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 N HICKORY RD STE 3, SOUTH BEND, IN 46615-3700
(574) 314-5987
Mailing address
13682 THISTLEWOOD CT, GRANGER, IN 46530-4720
(574) 335-9098
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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