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General NPI Number Information
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NPI Number | 1053875716
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Entity Type | Organization
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Legal Business Name | COLUMBIA HEALTH & WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 01/28/2019
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 3304 W BROADWAY BUSINESS PARK CT STE I
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City | COLUMBIA
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State | MO
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Zip | 65203-0109
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Country | US
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Telephone | 573-445-3702
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Fax | 573-445-3721
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Provider Business Mailing Address
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Address Line | 3304 W BROADWAY BUSINESS PARK CT STE I
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City | COLUMBIA
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State | MO
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Zip | 65203-0109
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Country | US
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Telephone | 573-445-3702
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Fax | 573-445-3721
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. STEPHANIE LEE MARSDEN
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Credential | DC
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Telephone | 573-445-3702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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