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General NPI Number Information
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NPI Number | 1174930317
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Entity Type | Organization
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Legal Business Name | THE CENTER OF WELLNESS
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 237 LOOKOUT PL SUITE 100
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City | MAITLAND
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State | FL
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Zip | 32751-8433
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Country | US
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Telephone | 407-335-4994
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Fax | 321-203-2512
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Provider Business Mailing Address
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Address Line | 237 LOOKOUT PL SUITE 100
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City | MAITLAND
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State | FL
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Zip | 32751-8433
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Country | US
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Telephone | 407-335-4994
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Fax | 321-203-2512
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JENNIFER HORNBURG
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Credential |
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Telephone | 407-256-7745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP2091/AP2330/AP2576
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH10263
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA23315
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License Number State | FL
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Taxonomy #4
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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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