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General NPI Number Information
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NPI Number | 1174078836
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Entity Type | Organization
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Legal Business Name | WAV MARKETING GROUP LLC
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 105 E JEFFERSON BLVD STE 500
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City | SOUTH BEND
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State | IN
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Zip | 46601-1922
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Country | US
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Telephone | 574-217-3508
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Fax |
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Provider Business Mailing Address
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Address Line | 105 E JEFFERSON BLVD STE 500
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City | SOUTH BEND
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State | IN
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Zip | 46601-1922
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Country | US
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Telephone | 574-217-3508
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | BRANDON CHARLES DICKSON
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Credential |
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Telephone | 574-217-3508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333300000X
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Taxonomy Name | Emergency Response System Companies
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License Number |
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License Number State |
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