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General NPI Number Information
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NPI Number | 1275406431
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Entity Type | Organization
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Legal Business Name | KNK WELLNESS LLC
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 8101 SANDY SPRING RD STE 210
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City | LAUREL
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State | MD
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Zip | 20707-3596
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Country | US
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Telephone | 240-673-7183
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Fax |
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Provider Business Mailing Address
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Address Line | 11503 BAYARD DR
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City | BOWIE
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State | MD
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Zip | 20721-2409
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Country | US
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Telephone | 202-573-6529
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARTIN NZEFEH
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Credential | NP
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Telephone | 240-673-7183
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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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