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General NPI Number Information
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NPI Number | 1356631535
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Entity Type | Organization
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Legal Business Name | WALK IN CLINIC LLC
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Dates
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Enumeration Date | 04/08/2011
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 207 W HIGH ST
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City | MOUNT VERNON
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State | OH
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Zip | 43050-2427
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Country | US
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Telephone | 740-392-0911
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Fax |
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Provider Business Mailing Address
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Address Line | 207 W HIGH ST
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City | MOUNT VERNON
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State | OH
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Zip | 43050-2427
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Country | US
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Telephone | 740-392-0911
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Fax |
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Authorized Official
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Title or Position | CNP
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Name | PHYLLIS ANN SIM
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Credential | MSN
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Telephone | 740-397-2655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | RN214125
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License Number State | OH
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