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General NPI Number Information
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NPI Number | 1659554277
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Entity Type | Organization
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Legal Business Name | SHANK & WELLS ENTERPRISES, LLC
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 2088 S LIBERTY DR SUITE 112
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City | BLOOMINGTON
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State | IN
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Zip | 47403-5171
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Country | US
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Telephone | 812-288-2222
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Fax | 812-288-2387
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Provider Business Mailing Address
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Address Line | 4536 S CHERRYWOOD ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4520
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Country | US
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Telephone |
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Fax | 812-299-8831
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. KARA M JAMES
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Credential |
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Telephone | 812-309-1711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 17001190A
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License Number State | IN
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