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General NPI Number Information
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NPI Number | 1477057966
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Entity Type | Organization
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Legal Business Name | STRONG HEALTH & WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 130 FAIRMONT ST STE B
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City | CLINTON
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State | MS
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Zip | 39056-4714
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Country | US
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Telephone | 601-473-2159
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Fax | 844-247-2866
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Provider Business Mailing Address
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Address Line | 130 FAIRMONT ST STE B
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City | CLINTON
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State | MS
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Zip | 39056-4714
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Country | US
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Telephone | 601-348-2001
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Fax | 844-247-2866
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | MARY STRONG
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Credential |
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Telephone | 601-613-1398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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