Organization
WANEE WALK IN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CINDY HAYES (DIRECTOR OF PHYSICIAN SERVICES)
(574) 523-3227
Entity
Organization
Contact information
Practice address
1028 E WATERFORD ST, SUITE A, WAKARUSA, IN 46573-9305
(574) 523-3227
(574) 296-6522
Mailing address
PO BOX 386, WAKARUSA, IN 46573-0386
(574) 523-3227
(574) 296-6522
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
01015929A
IN
261QX0100X
Occupational Medicine Clinic/Center
01015929A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200982600A
—
IN
Enumeration date
03/25/2010
Last updated
04/18/2011
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