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General NPI Number Information
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NPI Number | 1316320799
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Entity Type | Organization
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Legal Business Name | DEPAUW WELLNESS CLINIC
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Dates
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Enumeration Date | 07/03/2015
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 1 E OLIVE ST
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City | GREENCASTLE
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State | IN
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Zip | 46135
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Country | US
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Telephone | 765-658-4555
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 SOUTHFIELD DR STE 1370
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City | PLAINFIELD
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State | IN
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Zip | 46168-4300
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Country | US
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Telephone | 317-837-5566
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Fax | 317-837-5567
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | HEATHER RUTHERFORD
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Credential |
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Telephone | 317-837-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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