Healthcare Provider Details

I. General information

NPI: 1457834004
Provider Name (Legal Business Name): WELLNESS CONCEPTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 N MARKET ST STE C
CHATTANOOGA TN
37405-3908
US

IV. Provider business mailing address

PO BOX 4895
CHATTANOOGA TN
37405-0895
US

V. Phone/Fax

Practice location:
  • Phone: 423-541-1371
  • Fax:
Mailing address:
  • Phone: 423-541-1371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MEREDITH MASON
Title or Position: PRESIDENT
Credential: NP
Phone: 423-541-1371