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General NPI Number Information
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NPI Number | 1437567377
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Entity Type | Organization
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Legal Business Name | HORMONE HEALTH AND WEIGHT LOSS
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 6202 N 9TH AVE SUITE 4
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City | PENSACOLA
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State | FL
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Zip | 32504-8293
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Country | US
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Telephone | 850-462-9561
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Fax |
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Provider Business Mailing Address
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Address Line | 6202 NORTH 9TH AVENUE SUITE 4
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City | PENSACOLA
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State | FL
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Zip | 32504
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Country | US
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Telephone | 850-462-9561
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Fax |
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Authorized Official
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Title or Position | OFFICE COORDINATOR
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Name | AMANDA BLACKALL
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Credential |
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Telephone | 850-462-9561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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