Provider Demographics
NPI:1386068864
Name:WCC 2, LLC
Entity type:Organization
Organization Name:WCC 2, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATOYSHA
Authorized Official - Middle Name:SHANTA
Authorized Official - Last Name:DANGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-214-4286
Mailing Address - Street 1:5909 PEACHTREE DUNWOODY ROAD SUITE 900
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5388
Mailing Address - Country:US
Mailing Address - Phone:404-943-0205
Mailing Address - Fax:404-943-0209
Practice Address - Street 1:3023 N BALLAS RD BLDG D
Practice Address - Street 2:SUITE 120D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2330
Practice Address - Country:US
Practice Address - Phone:314-432-3669
Practice Address - Fax:314-432-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty