Healthcare Provider Details

I. General information

NPI: 1710538897
Provider Name (Legal Business Name): W3IG SWAP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8319 MICHIGAN RD
INDIANAPOLIS IN
46268-3635
US

IV. Provider business mailing address

6252 BISHOP POND LANE
INDIANAPOLIS IN
46268
US

V. Phone/Fax

Practice location:
  • Phone: 866-944-7927
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name: LAQUITA BARNES
Title or Position: PRESIDENT
Credential: CERT.HAIR LOSS SPEC.
Phone: 866-944-7927