Individual
JON DAL SANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
11360 BROADWAY, CROWN POINT, IN 46307-7197
(219) 600-4656
Mailing address
11360 BROADWAY, CROWN POINT, IN 46307-7197
(219) 600-4656
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
05013400A
IN
225100000X
Physical Therapist
Primary
05013400A
IN
Other
Enumeration date
08/05/2019
Last updated
07/16/2020
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