Provider Demographics
NPI:1750858460
Name:SLEEP HEALTH CENTER, PLLC
Entity Type:Organization
Organization Name:SLEEP HEALTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:WETZLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:502-822-1320
Mailing Address - Street 1:5200 BUTTONTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47122-9746
Mailing Address - Country:US
Mailing Address - Phone:502-931-4519
Mailing Address - Fax:
Practice Address - Street 1:130 FAIRFAX AVE STE 100C
Practice Address - Street 2:
Practice Address - City:SAINT MATTHEWS
Practice Address - State:KY
Practice Address - Zip Code:40207-4948
Practice Address - Country:US
Practice Address - Phone:502-822-1320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty