Individual
SUSAN BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6040 LUTE RD, PORTAGE, IN 46368-5008
(219) 763-6858
Mailing address
549 N 750W, HOBART, IN 46342
(219) 759-2287
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000314A
IN
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
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