| Hoosier Wellness Providers, Llc | |
|
637 S Walker St Bloomington IN 47403-2176 | |
| (561) 635-2400 | |
| Not Available |
| Full Name | Hoosier Wellness Providers, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 637 S Walker St, Bloomington, Indiana |
| Authorized Official Name and Position | Kirill Vesselov (MANAGER) |
| Authorized Official Contact | 5616352400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hoosier Wellness Providers, Llc 2925 10th Ave N Palm Springs FL 33461-3000 Ph: () - | Hoosier Wellness Providers, Llc 637 S Walker St Bloomington IN 47403-2176 Ph: (561) 635-2400 |
| NPI Number | 1730753294 |
|---|---|
| Provider Enumeration Date | 05/18/2021 |
| Last Update Date | 06/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730753294 | NPI | - | NPPES |
| 1467936070 | Other | IN | DAWN JOHNSON |
| 1497891840 | Other | IN | MICHAEL KANE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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