Organization
WHEELER CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA IVETTE LOPEZ (CASE MANAGER IV)
(860) 793-7241
Entity
Organization
Contact information
Practice address
458 GRAND AVE, NEW HAVEN, CT 06513-3856
(203) 752-1212
Mailing address
115 WOOD AVE FL 3, BRIDGEPORT, CT 06605-1046
(203) 584-5717
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
CT
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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