ADAM LEE WAUGH

SOUTH BEND, IN
NPI1487176293
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy222Z00000X Orthotist
(Licence: IL  213.000354)
Enumeration Date2017-07-13
Last Update Date2017-07-13
Business Address
Mr. ADAM LEE WAUGH MPO, CO
17530 DUGDALE DR
SOUTH BEND, IN 46635-1583
Phone number: 574-233-3352
Mailing Address
Mr. ADAM LEE WAUGH MPO, CO
17530 DUGDALE DR
SOUTH BEND, IN 46635-1583
Phone number: 574-233-3352
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