Organization
LA PORTE REGIONAL PHYSICIAN NETWORK
Active
Other names
Med Spa Obstetrics & Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA VOLK (EXECUTIVE DIRECTOR)
(219) 326-2485
Entity
Organization
Contact information
Practice address
601 KIEFFER RD, MICHIGAN CITY, IN 46360
(219) 879-6262
Mailing address
PO BOX 1690, LA PORTE, IN 46352-1690
(219) 326-2312
(219) 326-2584
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01052711
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100165070Z
—
IN
Enumeration date
06/01/2007
Last updated
06/06/2008
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