Healthcare Provider Details

I. General information

NPI: 1700885050
Provider Name (Legal Business Name): AP & C CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 OHIO BLVD SUITE 202
TERRE HAUTE IN
47803-2239
US

IV. Provider business mailing address

2901 OHIO BLVD SUITE 202
TERRE HAUTE IN
47803-2239
US

V. Phone/Fax

Practice location:
  • Phone: 812-232-2144
  • Fax: 812-234-4598
Mailing address:
  • Phone: 812-232-2144
  • Fax: 812-234-4598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number57000054A
License Number StateIN

VIII. Authorized Official

Name: DR. RICHARD G KENNEL
Title or Position: PRESIDENT OWNER
Credential: PH.D
Phone: 812-232-2144