Provider Demographics
NPI:1407114937
Name:WALBRIDGE WOODWORKS INC.
Entity Type:Organization
Organization Name:WALBRIDGE WOODWORKS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:LUETTKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-838-7275
Mailing Address - Street 1:27943 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-9408
Mailing Address - Country:US
Mailing Address - Phone:419-838-7275
Mailing Address - Fax:419-838-5235
Practice Address - Street 1:27943 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:WALBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43465-9408
Practice Address - Country:US
Practice Address - Phone:419-838-7275
Practice Address - Fax:419-838-5235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty