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General NPI Number Information
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NPI Number | 1003344417
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Entity Type | Organization
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Legal Business Name | HEALTHYWAY TODAY LLC
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 05/30/2017
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Provider Practice Location Address
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Address Line | 37282 31 MILE RD
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City | RICHMOND
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State | MI
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Zip | 48062-1931
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Country | US
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Telephone | 810-328-3118
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Fax |
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Provider Business Mailing Address
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Address Line | 9689 SAINT CLAIR HWY
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City | CASCO
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State | MI
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Zip | 48064-1109
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Country | US
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Telephone | 586-430-4075
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAWN CORDONE
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Credential | NP
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Telephone | 810-328-3118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4704175112
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704175112
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License Number State | MI
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