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General NPI Number Information
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NPI Number | 1619501939
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Entity Type | Organization
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Legal Business Name | CENTER OF ADVANCED WELLNESS, INC.
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 8723 BOTTS ST
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6334
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Country | US
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Telephone | 210-783-7333
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Fax |
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Provider Business Mailing Address
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Address Line | 8723 BOTTS ST
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6334
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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 | CEO
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Name | CHRIS CIANI
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Credential |
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Telephone | 813-944-8966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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