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General NPI Number Information
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NPI Number | 1093418410
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Entity Type | Organization
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Legal Business Name | CLAUDIA JEAN WELLNESS, LLC
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 116 BASS LAKE RD
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-7620
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Country | US
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Telephone | 919-762-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 2413 BALMOOR TRCE
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City | APEX
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State | NC
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Zip | 27523-8514
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Country | US
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Telephone | 919-215-2105
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CLAUDIA KLAVON
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Credential |
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Telephone | 919-215-2105
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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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