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Organization

MEDICINE REIMAGINED DPC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KIMBERLY STUCKEY-SCHROCK MD (MANAGER)
(574) 319-1420
Entity
Organization

Contact information

Practice address
1720 W LINCOLN AVE, GOSHEN, IN 46526-5906
(574) 319-1420
Mailing address
511 N GREENE RD, GOSHEN, IN 46526-1309
(574) 319-1420

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
04/10/2021
Last updated
05/05/2021
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