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General NPI Number Information
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NPI Number | 1366271744
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Entity Type | Organization
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Legal Business Name | ST. VINCENT HEALTH WELLNESS AND PREVENTIVE CARE INSTITUTE, INC.
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Dates
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Enumeration Date | 08/01/2024
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 2724 N 50 E
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City | KOKOMO
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State | IN
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Zip | 46901-8590
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Country | US
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Telephone | 765-236-8322
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Fax | 765-259-3744
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Provider Business Mailing Address
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Address Line | 2724 N 50 E
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City | KOKOMO
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State | IN
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Zip | 46901-8590
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO (AMG)
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Name | BRIAN MORRIS
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Credential |
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Telephone | 317-338-6234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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