Healthcare Provider Details

I. General information

NPI: 1750160156
Provider Name (Legal Business Name): WORLD OF WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 1ST AVE SE
CEDAR RAPIDS IA
52402-5123
US

IV. Provider business mailing address

590 CALLA LILLY WAY
TIFFIN IA
52340-9236
US

V. Phone/Fax

Practice location:
  • Phone: 319-853-1546
  • Fax:
Mailing address:
  • Phone: 319-853-1546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JENNIFER MICHELLE WILLIAMS
Title or Position: OWNER
Credential:
Phone: 319-853-1546