Individual
JONATHON WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
312 DUNN AVE, CRAWFORDSVILLE, IN 47933-3011
(812) 201-6225
Mailing address
312 DUNN AVE, CRAWFORDSVILLE, IN 47933-3011
(812) 201-6225
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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