Healthcare Provider Details

I. General information

NPI: 1316874522
Provider Name (Legal Business Name): INDIANA WESLEYAN UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 MANCHESTER AVE
WABASH IN
46992-1615
US

IV. Provider business mailing address

4411 S ADAMS ST
MARION IN
46953-5349
US

V. Phone/Fax

Practice location:
  • Phone: 260-563-5630
  • Fax:
Mailing address:
  • Phone: 765-674-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JEFF RAYIS
Title or Position: CFO
Credential:
Phone: 765-677-6573