Provider Demographics
NPI:1053707000
Name:WHOLESOME HOUSE
Entity type:Organization
Organization Name:WHOLESOME HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH CARE CONSULTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:K
Authorized Official - Last Name:PUTRUS-SCHNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-661-7879
Mailing Address - Street 1:1501 SAINT CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-8228
Mailing Address - Country:US
Mailing Address - Phone:812-661-7879
Mailing Address - Fax:
Practice Address - Street 1:1501 SAINT CHARLES ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-8228
Practice Address - Country:US
Practice Address - Phone:812-661-7879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002838A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty