Provider Demographics
NPI:1720388978
Name:WILLCARE
Entity Type:Organization
Organization Name:WILLCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICXAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:DELLOW
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:716-487-1131
Mailing Address - Street 1:220 FLUVANNA AVE SUITE 200
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14723
Mailing Address - Country:US
Mailing Address - Phone:716-487-1131
Mailing Address - Fax:716-487-1138
Practice Address - Street 1:220 FLUVANNA AVE SUITE 200
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14723
Practice Address - Country:US
Practice Address - Phone:716-487-1131
Practice Address - Fax:716-487-1138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health