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General NPI Number Information
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NPI Number | 1366806457
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Entity Type | Organization
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Legal Business Name | ADVANCED WELLNESS CENTER, P.C.
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 2442 MEINEN CT
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City | DUBUQUE
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State | IA
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Zip | 52002-2787
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Country | US
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Telephone | 563-556-6292
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Fax | 563-588-6286
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Provider Business Mailing Address
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Address Line | 2442 MEINEN CT
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City | DUBUQUE
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State | IA
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Zip | 52002-2787
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Country | US
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Telephone | 563-556-6292
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Fax | 563-588-6286
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | NICOLE SCHLOSSER
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Credential | MSN, FNP, ARNP
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Telephone | 563-556-6292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A100449
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License Number State | IA
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