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General NPI Number Information
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NPI Number | 1407970510
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE WELLNESS CENTER INC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1400 ESPLANADE AVE 1707 ELYSIAN FIELDS AVE
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City | NEW ORLEANS
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State | LA
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Zip | 70116-1803
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Country | US
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Telephone | 504-523-4103
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Fax | 504-523-5910
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Provider Business Mailing Address
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Address Line | 1400 ESPLANADE AVE 1707 ELYSIAN FIELDS AVENUE
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City | NEW ORLEANS
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State | LA
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Zip | 70116-1803
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Country | US
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Telephone | 504-523-4103
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Fax | 504-523-5910
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EDWARD J BURKHALTER
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Credential |
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Telephone | 504-523-4103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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