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General NPI Number Information
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NPI Number | 1487465159
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Entity Type | Organization
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Legal Business Name | K9 & EQUINE WELLNESS INCORPORATED
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 4075 MACLAND RD
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-1504
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Country | US
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Telephone | 770-530-0174
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Fax | 770-264-0098
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Provider Business Mailing Address
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Address Line | 4075 MACLAND RD
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-1504
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Country | US
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Telephone | 770-530-0174
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Fax | 770-264-0098
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY A TAPP
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Credential | MS
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Telephone | 770-530-0174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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