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General NPI Number Information
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NPI Number | 1619319282
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Entity Type | Organization
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Legal Business Name | ZEN HEALTH WELLNESS AND BEAUTY CLINIC
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 3875 ROBERT C. BYRD DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801-3875
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Country | US
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Telephone | 304-252-9890
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Fax | 304-252-9901
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Provider Business Mailing Address
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Address Line | 3875 ROBERT C. BYRD DRIVE
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City | BECKLEY
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State | WV
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Zip | 25801-3875
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Country | US
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Telephone | 304-252-9890
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Fax | 304-252-9901
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Authorized Official
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Title or Position | CLINIC MANAGER
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Name | MS. SELISA SHARON BHAVSAR
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Credential |
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Telephone | 304-252-9890
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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 | 11044
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License Number State | WV
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