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NPI Code Detail

MEDICARE: RADIX WELLNESS, LLC

MEDICARE: RADIX WELLNESS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM2500XMedical Specialty Clinic/Center

General Provider Information

NPI Number : 1497244909
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIX WELLNESS, LLC
Provider Business Mailing Address
First Line : 4716 W COMMERCE ST
Second Line :
City : HERNANDO
State : MS
Zip : 38632-8436
Country : US
Telephone Number : 901-828-8019
Fax Number : 662-449-0598
Provider Business Practice Location Address
First Line : 1314 PEABODY AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3500
Country : US
Telephone Number : 901-828-8019
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : MRS. MELISSA PADGETT
Credential : CPM
Telephone Number : 901-828-8019
Provider Enumeration Date : 05/09/2018
Last Update Date : 05/09/2018

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Directions to “RADIX WELLNESS, LLC ” Practice Location

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