AGELESS WELLNESS CENTER INC NPI 1245672856

NPI Information

AGELESS WELLNESS CENTER, INC is a general practice in Milwaukee, WI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee AGELESS WELLNESS CENTER, INC NPI is 1245672856. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2745 W LAYTON AVE
SUITE 203
MILWAUKEE, WI
ZIP 53221-651
Phone: (414) 475-5800
Fax: (414) 475-5400

The provider's authorized official is Abdullattief A Sulieman .
The authorized official title is President/owner and has the following contact phone number (414) 475-5800.

The CLIA number assigned to this NPI record is 52D2063719 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/24/2013 and was last updated on 5/2/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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