Provider Information for 1093940256
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BELINDA C WITHEROW MS
Sex: Female
NPI: 1093940256
Last Updated: 2010-06-29
Certification Date:
Certification Date:
Details
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NPI | 1093940256 | ||||||||
Enumeration Date | 2009-05-18 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 1501 STATE ST LA PORTE, IN 46350-3115 United States Phone: 219-362-5000 | Fax:219-362-5005 | ||||||||
Primary Practice Address | 1501 STATE ST LA PORTE, IN 46350-3115 United States Phone: 219-362-5000 | Fax:219-362-5005 | ||||||||
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