Organization
DIRECTCLINIC SBC, LLC
Active
Other names
DirectClinic
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHAKAR SANTHANA KRISHNAN (CEO)
(260) 750-0418
Entity
Organization
Contact information
Practice address
300 W OHIO ST, KENDALLVILLE, IN 46755-2018
(260) 212-1906
Mailing address
1355 GETZ RD STE C, FORT WAYNE, IN 46804-1609
(260) 212-1900
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/30/2021
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