Organization
JGWHARTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA BEDWELL (DELEGATED OFFICAL)
(317) 268-6555
Entity
Organization
Contact information
Practice address
4265 E MAIN ST, AVON, IN 46123-9174
(317) 268-6555
(317) 268-6556
Mailing address
4265 E MAIN ST, AVON, IN 46123-9174
(317) 268-6555
(317) 268-6556
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
—
—
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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