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General NPI Number Information
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NPI Number | 1770367468
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Entity Type | Organization
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Legal Business Name | WELLTRACKONE CORPORATION
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 32 OFFICE PARK RD STE 213
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29928-4640
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Country | US
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Telephone | 843-341-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 32 OFFICE PARK RD STE 213
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29928-4640
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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 | PAYER ENROLLMENT MANAGER
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Name | WENDY A BYRNE
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Credential |
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Telephone | 951-503-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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