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General NPI Number Information
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NPI Number | 1235952045
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Entity Type | Organization
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Legal Business Name | MEET AT THE WELL LLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 217 W PEACE ST
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City | CANTON
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State | MS
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Zip | 39046-4325
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Country | US
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Telephone | 601-691-2277
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Fax |
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Provider Business Mailing Address
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Address Line | 402 AUDUBON WOODS
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City | CANTON
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State | MS
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Zip | 39046-8883
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Country | US
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Telephone | 470-496-7066
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. VERNON TROY BROWN JR.
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Credential |
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Telephone | 470-496-7066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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