Organization
TERRE HAUTE NEUROSURGICAL & SPINE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. G ANDREW WILSON JR. M.D. (OWNER)
(812) 238-4900
Entity
Organization
Contact information
Practice address
1530 N 7TH ST, SUITE 107, TERRE HAUTE, IN 47807-1057
(812) 238-4900
(812) 238-4921
Mailing address
1530 N 7TH ST, SUITE 107, TERRE HAUTE, IN 47807-1057
(812) 238-4900
(812) 238-4921
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
01057579A
IN
Other
Enumeration date
05/15/2007
Last updated
02/10/2014
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