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General NPI Number Information
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NPI Number | 1356864938
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Entity Type | Organization
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Legal Business Name | THE HEALTHY HEDGEHOG WELLNESS COACH, LLC
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 137 S HAMILTON ST
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City | GEORGETOWN
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State | KY
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Zip | 40324-1671
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Country | US
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Telephone | 502-542-3326
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Fax |
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Provider Business Mailing Address
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Address Line | 3138 FRANKFORT RD
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City | GEORGETOWN
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State | KY
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Zip | 40324-9465
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Country | US
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Telephone | 859-533-5331
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Fax |
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Authorized Official
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Title or Position | FAMILY PHYSICIAN
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Name | DR. ANN RODDEN
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Credential | DO
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Telephone | 502-542-3326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 03480
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License Number State | KY
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