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General NPI Number Information
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NPI Number | 1043039324
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Entity Type | Organization
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Legal Business Name | THE WELL AESTHETICS AND WELLNESS PLLC
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 106 OLD STAGE RD UNIT A
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City | SALIDA
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State | CO
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Zip | 81201-8938
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Country | US
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Telephone | 719-626-4389
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Fax |
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Provider Business Mailing Address
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Address Line | 9996 W US HIGHWAY 50 STE 1071
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City | SALIDA
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State | CO
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Zip | 81201-9811
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Country | US
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Telephone | 719-626-4389
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Fax |
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Authorized Official
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Title or Position | OWNER, APRN
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Name | SARAH LAING
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Credential | APRN
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Telephone | 405-412-7788
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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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