Organization
WABASH VALLEY INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A BOLINGER D.O. (OWNER)
(812) 448-1701
Entity
Organization
Contact information
Practice address
6898 N COUNTY ROAD 375 W, BRAZIL, IN 47834-7262
(812) 448-1701
Mailing address
6898 N COUNTY ROAD 375 W, BRAZIL, IN 47834-7262
(812) 448-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02001231
IN
Other
Enumeration date
11/13/2006
Last updated
08/22/2020
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