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General NPI Number Information
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NPI Number | 1336308055
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Entity Type | Organization
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Legal Business Name | CENTER FOR HEALING & WELLNESS, P.C.
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Dates
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Enumeration Date | 06/06/2008
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 401 JACKSON AVE E
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City | OXFORD
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State | MS
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Zip | 38655-3809
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Country | US
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Telephone | 662-236-5773
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Fax | 662-236-5844
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Provider Business Mailing Address
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Address Line | 401 JACKSON AVE E
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City | OXFORD
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State | MS
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Zip | 38655-3809
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Country | US
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Telephone | 662-236-5773
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Fax | 662-236-5844
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. I. HARRISON EVANS
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Credential | MD
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Telephone | 662-236-5773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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