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General NPI Number Information
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NPI Number | 1134792476
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Entity Type | Organization
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Legal Business Name | WEALTH INFUSION & WELLNESS CLINIC INC
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 1101 E BARDIN RD STE 141
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City | ARLINGTON
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State | TX
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Zip | 76018-1150
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Country | US
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Telephone | 240-423-9391
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Fax |
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Provider Business Mailing Address
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Address Line | 204 CAPTAINS CT
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City | MANSFIELD
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State | TX
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Zip | 76063-6838
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Country | US
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Telephone | 240-423-9391
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | OLASUNKANMI IRANLOYE
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Credential | NP
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Telephone | 240-423-9391
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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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