| The Well Wagon, Llc | |
|
2124 Dogoon Dr Louisville KY 40223-1147 | |
| (812) 430-2633 | |
| Not Available |
| Full Name | The Well Wagon, Llc |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 2124 Dogoon Dr, Louisville, Kentucky |
| Authorized Official Name and Position | Kimberly M Spahn (CEO, OWNER) |
| Authorized Official Contact | 8124302633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Well Wagon, Llc 2124 Dogoon Dr Louisville KY 40223-1147 Ph: () - | The Well Wagon, Llc 2124 Dogoon Dr Louisville KY 40223-1147 Ph: (812) 430-2633 |
| NPI Number | 1598363509 |
|---|---|
| Provider Enumeration Date | 10/12/2020 |
| Last Update Date | 10/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598363509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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