Organization
SQUAREONE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN WILLIAMS (PRESIDENT/CEO)
(317) 698-7274
Entity
Organization
Contact information
Practice address
5422 N KEYSTONE AVE, INDIANAPOLIS, IN 46220
(317) 698-7274
Mailing address
5422 N KEYSTONE AVE, INDIANAPOLIS, IN 46220-3456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
08/30/2017
Last updated
08/24/2018
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