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General NPI Number Information
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NPI Number | 1063287068
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Entity Type | Organization
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Legal Business Name | INSPIRE WELLNESS LLC
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 110 WOODCREST DR
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City | HIGHLAND
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State | IL
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Zip | 62249-1255
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Country | US
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Telephone | 618-651-0535
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Fax | 949-703-7873
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Provider Business Mailing Address
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Address Line | 2568 BECKER RD
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City | HIGHLAND
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State | IL
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Zip | 62249-3038
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Country | US
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Telephone | 618-920-7094
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Fax |
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Authorized Official
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Title or Position | NP/OWNER
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Name | KELSEY L REDING
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Credential | NP
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Telephone | 618-651-0535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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