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General NPI Number Information
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NPI Number | 1619062445
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE WELLNESS CLINIC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 714 NORTH POMME DE TERRE ROAD
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City | BOLIVAR
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State | MO
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Zip | 65613
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Country | US
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Telephone | 417-326-7272
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Fax | 417-326-2193
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Provider Business Mailing Address
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Address Line | PO BOX 49
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City | BOLIVAR
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State | MO
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Zip | 65613
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Country | US
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Telephone | 417-326-7272
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Fax | 417-326-2193
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHN FRANK HOWELL
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Credential | PSYD, BCFM
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Telephone | 417-326-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY01322
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | RIJ41
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License Number State | MO
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