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General NPI Number Information
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NPI Number | 1609273408
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Entity Type | Organization
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Legal Business Name | QUALITY HEALTHCARE & HOLISTIC CLINIC, LLC
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Dates
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Enumeration Date | 11/24/2014
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Last Update Date | 11/24/2014
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Provider Practice Location Address
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Address Line | 226 S QUINTARD AVE STE C
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City | ANNISTON
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State | AL
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Zip | 36201-6070
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Country | US
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Telephone | 256-403-1025
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2146
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City | ANNISTON
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State | AL
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Zip | 36202-2146
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DR
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Name | JOSE OBLENA
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Credential | MD
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Telephone | 256-403-1025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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