Organization
WANEE WALK IN CLINIC LLC
Active
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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