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General NPI Number Information
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NPI Number | 1124038534
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Entity Type | Organization
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Legal Business Name | HEALTH AND WELLNESS CENTER
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 338 S DAKOTA AVE
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City | VANDENBERG AFB
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State | CA
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Zip | 93437-6307
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Country | US
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Telephone | 805-606-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 338 S DAKOTA AVE BLDG 13850
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City | VANDENBERG AFB
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State | CA
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Zip | 93437-6307
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Country | US
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Telephone | 805-606-2221
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | MRS. MELINDA S REED
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Credential | RD
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Telephone | 805-606-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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