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Individual

MR. ADAM LEE WAUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MPO, CO

Contact information

Practice address
17530 DUGDALE DR, SOUTH BEND, IN 46635-1583
(574) 233-3352
Mailing address
17530 DUGDALE DR, SOUTH BEND, IN 46635-1583
(574) 233-3352

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
213.000354
IL

Other

Enumeration date
07/13/2017
Last updated
07/13/2017
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