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3386 Co. Rd. 427, Waterloo, IN 46793 | |
(260) 837-6331 | |
(260) 837-7938 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 3386 Co. Rd. 427, Waterloo, Indiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1639283880 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 08002021A (Indiana) | Primary |
Provider Name | Nicholas J Sullivan |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1083868863 PECOS PAC ID: 1456418318 Enrollment ID: I20090319000431 |
Provider Name | Lee J Nagel |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1124030101 PECOS PAC ID: 6305987827 Enrollment ID: I20100106000454 |
Mailing Address | Practice Location Address |
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Po Box 477, Waterloo, IN 46793-0477 Ph: (260) 837-6331 | 3386 Co. Rd. 427, Waterloo, IN 46793 Ph: (260) 837-6331 |
Lee Joseph Nagel, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 3386 Co. Rd. 427, Waterloo, IN 46793 Phone: 260-837-6331 Fax: 260-837-7938 |