| Organization Name: | WELLNESS GROUP, P.C. |
| NPI Number: | 1013262351 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANE BRADLAW (CHAIRMAN) |
| Mailing Address: | 802 Laporte Ave Porter Hospital Wound Care Center Valparaiso |
| State: | IN US |
| Postal Code: | 463835860 |
| Phone Number: | 2192634600 |
| Fax Number: | |
| NPI Enumeration Date: | 07/23/2012 |
| NPI Last Update Date: | 03/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0002X |
| License Number: | 02003905B |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Emergency Care |
| Taxonomy Definition: | |