MEDICARE: EAST WIND WELLNESS INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	84000190A	IN

General Provider Information

NPI Number	:	1255849915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST WIND WELLNESS INCORPORATED

Provider Business Mailing Address
First Line	:	3812 CROSBY DR
Second Line	:
City	:	VALPARAISO
State	:	IN
Zip	:	46383-6223
Country	:	US
Telephone Number	:	219-242-9958
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 INDIANAPOLIS BLVD STE 1A
Second Line	:
City	:	HIGHLAND
State	:	IN
Zip	:	46322-2664
Country	:	US
Telephone Number	:	219-595-5529
Fax Number	:	219-513-9273

Authorized Official
Title or Position	:	CEO
Name	:	MR. TIMOTHY DAVID SCHLANK
Credential	:	LAC
Telephone Number	:	219-242-9958

Provider Enumeration Date	:	01/16/2018
Last Update Date	:	01/16/2018

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Directions to “EAST WIND WELLNESS INCORPORATED ” Practice Location

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