Organization
ST. JOHN THERAPY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IAN C CABALLES P.T (ADMINISTRATOR)
(219) 716-0030
Entity
Organization
Contact information
Practice address
9111 BROADWAY, SUITE MM, MERRILLVILLE, IN 46410-8122
(219) 750-9763
Mailing address
10197 BACKWATER CV, SAINT JOHN, IN 46373-7008
(219) 750-9763
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05006512A
IN
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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