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General NPI Number Information
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NPI Number | 1508471418
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Entity Type | Organization
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Legal Business Name | WATERLOO URGENT CARE WALK IN CLINIC COMPANY
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 901 ILLINOIS ROUTE 3
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City | WATERLOO
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State | IL
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Zip | 62298
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Country | US
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Telephone | 313-948-3055
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Fax | 248-250-6430
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Provider Business Mailing Address
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Address Line | 14671 TELEGRAPH RD
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City | REDFORD
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State | MI
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Zip | 48239-3300
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Country | US
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Telephone | 131-394-8305
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Fax | 313-948-3041
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Authorized Official
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Title or Position | BUSINESS OPERATIONS MANAGER
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Name | NANCY MOLNAR
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Credential |
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Telephone | 313-948-3055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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