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General NPI Number Information
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NPI Number | 1053707000
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Entity Type | Organization
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Legal Business Name | WHOLESOME HOUSE
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 1501 SAINT CHARLES ST
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City | JASPER
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State | IN
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Zip | 47546-8228
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Country | US
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Telephone | 812-661-7879
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 SAINT CHARLES ST
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City | JASPER
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State | IN
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Zip | 47546-8228
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Country | US
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Telephone | 812-661-7879
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Fax |
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Authorized Official
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Title or Position | HEALTH CARE CONSULTANT
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Name | DR. AMY K PUTRUS-SCHNELL
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Credential | D.C.
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Telephone | 812-661-7879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08002838A
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License Number State | IN
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