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General NPI Number Information
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NPI Number | 1033754114
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Entity Type | Organization
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Legal Business Name | G2 WELLNESS INC.
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Dates
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Enumeration Date | 11/12/2019
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Last Update Date | 11/12/2019
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Provider Practice Location Address
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Address Line | 15500 W HWY 71 STE B-250
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City | BEE CAVE
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State | TX
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Zip | 78738-2813
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Country | US
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Telephone | 512-387-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2905 CORBIN LN
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City | AUSTIN
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State | TX
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Zip | 78704-5509
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Country | US
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Telephone | 512-964-0158
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Fax | 512-964-0158
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CHRISTIE LYNN GARBE
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Credential | MA
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Telephone | 512-964-0158
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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 |
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License Number State |
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