| Hoosier Wellness Providers, Llc | |
|
421 W 1st St Bloomington IN 47403-2403 | |
| (561) 635-2400 | |
| Not Available |
| Full Name | Hoosier Wellness Providers, Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 421 W 1st St, Bloomington, Indiana |
| Authorized Official Name and Position | Kirill Vesselov (PRESIDENT) |
| Authorized Official Contact | 5616352400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hoosier Wellness Providers, Llc 2925 10th Ave N Palm Springs FL 33461-3000 Ph: () - | Hoosier Wellness Providers, Llc 421 W 1st St Bloomington IN 47403-2403 Ph: (561) 635-2400 |
| NPI Number | 1023886488 |
|---|---|
| Provider Enumeration Date | 12/15/2023 |
| Last Update Date | 12/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023886488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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