Individual
PETER STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
11450 BROADWAY, CROWN POINT, IN 46307-7106
(219) 488-0157
(219) 661-2502
Mailing address
11450 BROADWAY, CROWN POINT, IN 46307-7106
(219) 488-0157
(219) 661-2502
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05006990A
IN
Other
Enumeration date
07/10/2006
Last updated
12/18/2007
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