Healthcare Provider Details

I. General information

NPI: 1750495156
Provider Name (Legal Business Name): FULL LIFE WELLNESS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 TITAN DR
FLORENCE AL
35630-1197
US

IV. Provider business mailing address

156 TITAN DR
FLORENCE AL
35630-1197
US

V. Phone/Fax

Practice location:
  • Phone: 256-740-0690
  • Fax: 256-740-0694
Mailing address:
  • Phone: 256-740-0690
  • Fax: 256-740-0694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: HOWARD DOUGLAS WOODFORD
Title or Position: OWNER
Credential:
Phone: 256-740-0690