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General NPI Number Information
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NPI Number | 1881415040
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Entity Type | Organization
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Legal Business Name | FRONTLINE WELLNESS CENTER PLLC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 151 WENDOVER DR STE B
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City | KINGSPORT
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State | TN
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Zip | 37663-2655
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Country | US
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Telephone | 423-712-1176
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Fax |
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Provider Business Mailing Address
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Address Line | 151 WENDOVER DR STE B
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City | KINGSPORT
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State | TN
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Zip | 37663-2655
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Country | US
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Telephone | 423-712-1176
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Fax | 423-717-5536
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Authorized Official
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Title or Position | OWNER
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Name | ROBIN HEBERT
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Credential | LPC/MHSP
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Telephone | 423-712-1176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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