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General NPI Number Information
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NPI Number | 1194526681
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Entity Type | Organization
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Legal Business Name | APPALACHIAN HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 1005 E STATE ST
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City | ATHENS
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State | OH
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Zip | 45701-2151
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Country | US
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Telephone | 740-249-9276
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 E STATE ST STE J
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City | ATHENS
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State | OH
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Zip | 45701-2151
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Country | US
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Telephone | 740-249-9276
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | BRANDON BOLHA
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Credential |
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Telephone | 740-249-9276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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