Organization
INDIANA WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS MENNEN (BUSINESS MANAGER)
(765) 479-1358
Entity
Organization
Contact information
Practice address
1221 S CREASY LN STE K3, LAFAYETTE, IN 47905-7430
(765) 379-1358
(765) 838-1035
Mailing address
1221 S CREASY LN STE K3, LAFAYETTE, IN 47905-7430
(765) 379-1358
(765) 838-1035
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01060426A
IN
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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