NPI Provider: 1154326668
Contact Name: BOSTIC LOUELLEN CONNIE
Position: PRESIDENT
Phone: (574) 739-0004
Twin Rivers Medical Laboratory, Inc Information:
Twin Rivers Medical Laboratory, Inc organization have npi 1154326668, taxonomy code is 291U00000X with license number is 18411 in . This Business address located in 902 W. Broadway, Logansport, IN 46947 Indiana.
Practice Location
Address: 902 W. Broadway, Logansport, IN 46947
Phone: (574) 739-0004
Business Location
Address: 902 W. Broadway, Logansport, IN 46947
Phone: (574) 739-0004
Fax: (574) 739-0105
Taxonomy
Taxonomy Code: 291U00000X
License Number: 18411
License Number of State: IN
Primary Taxonomy Switch: Y
Enumeration Date: 6/21/2005
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