=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447135918
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABSOLUTE HEALTH TOTAL BODY WELLNESS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2025
-----------------------------------------------------
Last Update Date | 09/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 620 GUILFORD COLLEGE RD STE B
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27409-2027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-482-1657
-----------------------------------------------------
Fax | 336-291-8560
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 620 GUILFORD COLLEGE RD STE B
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27409-2027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-482-1657
-----------------------------------------------------
Fax | 336-291-8560
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AMANDA KELLY EGGLESTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 336-482-1657
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------