Provider First Line Business Practice Location Address:
CALUMET HIGH SCHOOL
Provider Second Line Business Practice Location Address:
3900 CALHOUN ST., DOOR R
Provider Business Practice Location Address City Name:
GARY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-240-1851
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2021