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Organization
MARY WELLER
Active
Organization
MARY WELLER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY WELLER (RN)
(937) 215-8170
Entity
Organization
Contact information
Practice address
3331 WENDOVER ST, SPRINGFIELD, OH 45506-4315
(931) 215-8170
Mailing address
3331 WENDOVER ST, SPRINGFIELD, OH 45506-4315
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
03/04/2015
Last updated
03/04/2015
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