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General NPI Number Information
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NPI Number | 1568870038
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Entity Type | Organization
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Legal Business Name | NATURAL HEALTH AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 2424 AIRWAY DR STE B
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City | BOWLING GREEN
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State | KY
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Zip | 42103-7125
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Country | US
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Telephone | 270-843-6781
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Fax | 270-746-0204
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Provider Business Mailing Address
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Address Line | 2424 AIRWAY DR STE B
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City | BOWLING GREEN
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State | KY
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Zip | 42103-7125
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Country | US
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Telephone | 270-843-6781
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Fax | 270-746-0204
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Authorized Official
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Title or Position | MEMBER
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Name | JODIE A HAWLEY
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Credential |
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Telephone | 270-843-6781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4859
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 1093908
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License Number State | KY
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