Healthcare Provider Details

I. General information

NPI: 1407001365
Provider Name (Legal Business Name): WELLSVILLE LOCAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 11/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 CENTER ST
WELLSVILLE OH
43968-1423
US

IV. Provider business mailing address

929 CENTER ST
WELLSVILLE OH
43968-1423
US

V. Phone/Fax

Practice location:
  • Phone: 330-532-2643
  • Fax: 330-532-6204
Mailing address:
  • Phone: 330-532-2643
  • Fax: 330-532-6204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: COLEEN M WICKHAM
Title or Position: TREASURER
Credential:
Phone: 330-532-2643