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General NPI Number Information
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NPI Number | 1437669066
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Entity Type | Organization
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Legal Business Name | ULTIMATE HEALTH & WELLNESS, LLC
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 10/11/2017
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Provider Practice Location Address
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Address Line | 2862 WHITEHALL BLVD
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City | WHITEHALL
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State | WV
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Zip | 26554
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Country | US
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Telephone | 681-443-3141
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Fax | 681-443-3142
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Provider Business Mailing Address
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Address Line | 1610 BOBBECK LANE
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City | FAIRMONT
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State | WV
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Zip | 26554
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Country | US
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Telephone | 681-443-3141
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Fax | 681-443-3142
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Authorized Official
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Title or Position | OWNER
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Name | ROLANDO PARAOAN GARCIA
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Credential | NMD
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Telephone | 304-612-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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