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General NPI Number Information
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NPI Number | 1063930824
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Entity Type | Organization
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Legal Business Name | HEALING HANDS WELLNESS CLINIC LLC
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 09/22/2017
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Provider Practice Location Address
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Address Line | 4707 WOODRIDGE DR
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City | MEMPHIS
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State | TN
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Zip | 38116-7811
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Country | US
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Telephone | 901-808-5172
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Fax |
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Provider Business Mailing Address
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Address Line | 3194 ESTES ST
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City | MEMPHIS
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State | TN
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Zip | 38115-2903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. SEANDRIA F EVANS
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Credential |
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Telephone | 901-808-5172
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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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