Provider Demographics
NPI:1134852015
Name:WANDLING, WILLIAIM P
Entity type:Individual
Prefix:
First Name:WILLIAIM
Middle Name:P
Last Name:WANDLING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 SWIGART RD
Mailing Address - Street 2:
Mailing Address - City:NEW FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4729
Mailing Address - Country:US
Mailing Address - Phone:330-524-4808
Mailing Address - Fax:
Practice Address - Street 1:1506 SWIGART RD
Practice Address - Street 2:
Practice Address - City:NEW FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:44203-4729
Practice Address - Country:US
Practice Address - Phone:330-524-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No347E00000XTransportation ServicesTransportation Broker