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General NPI Number Information
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NPI Number | 1447035589
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Entity Type | Organization
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Legal Business Name | VETERANS WELLNESS GROUP, LLC
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 208 WESTMINSTER DR
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City | LEWISVILLE
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State | TX
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Zip | 75056-5888
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Country | US
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Telephone | 469-601-1678
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Fax |
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Provider Business Mailing Address
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Address Line | 208 WESTMINSTER DR
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City | LEWISVILLE
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State | TX
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Zip | 75056-5888
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Country | US
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Telephone | 469-601-1678
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | STEPHANIE SEWELL
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Credential |
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Telephone | 469-601-1678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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