HOLISTIC MEDICAL AND WELLNESS CENTER OF IN LLC NPI 1336478890

NPI Information

HOLISTIC MEDICAL AND WELLNESS CENTER OF IN, LLC is a primary care clinic center in Indianapolis, IN. HOLISTIC MEDICAL AND WELLNESS CENTER OF IN, LLC NPI is 1336478890. The provider is registered as an organization entity type.

The provider's business location address is:

8424 NAAB RD
SUITE 3P
INDIANAPOLIS, IN
ZIP 46260-918
Phone: (317) 608-6090
Fax: (317) 608-6095

The provider's authorized official is Randee L Miller .
The authorized official title is Nurse Practitioner/owner and has the following contact phone number (317) 608-6090.

The CLIA number assigned to this NPI record is 15D2002348 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/12/2009 and was last updated on 12/12/2009.

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

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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