| Wallace Kettering Neuroscience Institute | |
|
3533 Southern Blvd Suite 5200 Kettering OH 45429-1275 | |
| (937) 395-8043 | |
| (937) 395-8139 |
| Full Name | Wallace Kettering Neuroscience Institute |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 3533 Southern Blvd, Kettering, Ohio |
| Authorized Official Name and Position | Daniel D Haibach (DIRECTOR BUSINESS DEVELOPMENT) |
| Authorized Official Contact | 9375583222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wallace Kettering Neuroscience Institute 2110 Leiter Rd Miamisburg OH 45342-3660 Ph: (937) 384-4838 | Wallace Kettering Neuroscience Institute 3533 Southern Blvd Suite 5200 Kettering OH 45429-1275 Ph: (937) 395-8043 |
| NPI Number | 1285916585 |
|---|---|
| Provider Enumeration Date | 09/13/2011 |
| Last Update Date | 09/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285916585 | NPI | - | NPPES |
| 2712872 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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