Organization
IN HOME HEALTH, LLC
Active
Other names
ProMedica Hospice (Fond du Lac)
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN DAVID ALLEN (DIRECTOR)
(419) 252-5734
Entity
Organization
Contact information
Practice address
N6650 ROLLING MEADOWS DR STE 1, FOND DU LAC, WI 54937-9471
(920) 926-1144
Mailing address
333 N SUMMIT ST, TOLEDO, OH 43604-1531
(567) 585-1191
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43190700
—
WI
Enumeration date
10/11/2022
Last updated
10/11/2022
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