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General NPI Number Information
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NPI Number | 1033307665
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Entity Type | Organization
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Legal Business Name | NEUROPRAXIS PC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 270 E 90TH DR
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City | MERRILLVILLE
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State | IN
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Zip | 46410-8102
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Country | US
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Telephone | 219-736-6475
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11148
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City | MERRILLVILLE
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State | IN
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Zip | 46411-1148
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARC DESHAIES
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Credential | MD
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Telephone | 773-251-2719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State |
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