Organization
FAMILY AND ALTERNATIVE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELORSE LYNNE KRUG OFFICE MANAGER (OWNER)
(765) 362-7600
Entity
Organization
Contact information
Practice address
601 MILL ST, CRAWFORDSVILLE, IN 47933-3440
(765) 362-7600
Mailing address
1627 W COUNTRY CLUB RD, CRAWFORDSVILLE, IN 47933-2206
(765) 362-4551
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
Primary
02001756A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200172010
—
IN
Enumeration date
06/29/2007
Last updated
08/11/2008
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