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General NPI Number Information
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NPI Number | 1326406638
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Entity Type | Organization
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Legal Business Name | FOREVER WELLNESS
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 02/01/2016
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Provider Practice Location Address
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Address Line | 508 W MAIN ST
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City | ALLEN
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State | TX
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Zip | 75013-2712
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Country | US
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Telephone | 469-656-1712
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Fax | 469-656-1774
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Provider Business Mailing Address
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Address Line | 508 W MAIN ST
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City | ALLEN
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State | TX
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Zip | 75013-2712
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Country | US
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Telephone | 469-656-1712
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Fax | 469-656-1774
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAIME ANN FRANCESCANGELI
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Credential | DC
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Telephone | 469-656-1712
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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 | 10873
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License Number State | TX
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