Provider Demographics
NPI:1346363934
Name:OSOLO OCCUPATIONAL MEDICINE PC
Entity Type:Organization
Organization Name:OSOLO OCCUPATIONAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-266-6662
Mailing Address - Street 1:26076 COUNTY ROAD 6
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-5512
Mailing Address - Country:US
Mailing Address - Phone:574-266-6662
Mailing Address - Fax:574-266-6596
Practice Address - Street 1:26076 COUNTY ROAD 6
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-5512
Practice Address - Country:US
Practice Address - Phone:574-266-6662
Practice Address - Fax:574-266-6596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine