NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1033161617 |   |   |   | BEACON MEDICAL GROUP, INC. | 710 N NILES AVE | SOUTH BEND | IN | 466171924 |
1114145687 | PENNINGTON | JENNIFER | ANNE |   | 710 N NILES AVE | SOUTH BEND | IN | 466171924 |