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General NPI Number Information
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NPI Number | 1891182598
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Entity Type | Organization
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Legal Business Name | WELNUFIT LLC
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 132 SOUTHWOOD DR
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City | LANCASTER
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State | TX
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Zip | 75146-2826
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Country | US
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Telephone | 800-680-4039
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 INNOVATOR DR UNIT 19102
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City | SACRAMENTO
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State | CA
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Zip | 95834-3897
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Country | US
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Telephone | 972-426-6809
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Fax | 972-426-6809
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Authorized Official
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Title or Position | CEO
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Name | MRS. TONYA R BUTLER
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Credential |
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Telephone | 800-680-4039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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