Healthcare Provider Details
I. General information
NPI: 1750877270
Provider Name (Legal Business Name): NUVO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2018
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3001 MCCLELLAN BLVD
ANNISTON AL
36201-2724
US
IV. Provider business mailing address
PO BOX 1794
ANNISTON AL
36202-1794
US
V. Phone/Fax
- Phone: 256-237-9423
- Fax: 256-237-6007
- Phone: 256-237-9423
- Fax: 256-237-6007
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NI0013X |
| Taxonomy | Independent Medical Examiner Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
LISA
S
WADE
Title or Position: MEMBER
Credential:
Phone: 256-237-9423