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1619694882
WILLIAM OTIS HAINES
FORT WAYNE, IN
NPI
1619694882
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: IN 45023378A)
Enumeration Date
2022-10-27
Last Update Date
2022-10-27
Business Address
WILLIAM OTIS HAINES
770 E DUPONT RD
FORT WAYNE, IN 46825-2056
Phone number: 260-451-8242
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Mailing Address
WILLIAM OTIS HAINES
9433 BOBCAT TRL
LEO, IN 46765-9360
Phone number: 260-437-4643
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