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General NPI Number Information
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NPI Number | 1326911462
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Entity Type | Organization
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Legal Business Name | WHOLE LIVING MEDICAL
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1141 16TH ST
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City | BEDFORD
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State | IN
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Zip | 47421-3721
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Country | US
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Telephone | 812-674-8606
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Fax | 812-260-9223
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Provider Business Mailing Address
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Address Line | 1141 16TH ST
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City | BEDFORD
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State | IN
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Zip | 47421-3721
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Country | US
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Telephone | 812-674-8606
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Fax | 812-260-9223
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Authorized Official
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Title or Position | PROVIDER
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Name | SAMANTHA FRITCH
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Credential | FNP-BC
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Telephone | 812-674-8606
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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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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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