Basic Information
| Provider Information | |||||||||
| NPI: | 1922467562 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LAPORTE OCCUPATIONAL HEALTH SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 689022 | ||||||||
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| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370689022 | ||||||||
| CountryCode: | US | ||||||||
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| FaxNumber: | 6156286287 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 BOYD BLVD | ||||||||
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| City: | LA PORTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463503965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2193262664 | ||||||||
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| ProviderEnumerationDate: | 02/10/2016 | ||||||||
| LastUpdateDate: | 02/10/2016 | ||||||||
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| AuthorizedOfficialLastName: | SWAW | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6157788076 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083X0100X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.