| Pwa & Spencer Home Llc | |
|
27 Pequignot Dr Pierceton IN 46562-9081 | |
| (260) 702-3752 | |
| (866) 681-7794 |
| Full Name | Pwa & Spencer Home Llc |
|---|---|
| Speciality | Counselor |
| Location | 27 Pequignot Dr, Pierceton, Indiana |
| Authorized Official Name and Position | Kolby Rutherford (VP OF FINANCE & CONTROLLER) |
| Authorized Official Contact | 2607023640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pwa & Spencer Home Llc 4150 Illinois Rd Fort Wayne IN 46804-1208 Ph: (260) 702-3640 | Pwa & Spencer Home Llc 27 Pequignot Dr Pierceton IN 46562-9081 Ph: (260) 702-3752 |
| NPI Number | 1558025734 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 07/19/2024 |
| Certification Date | 07/19/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558025734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |