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General NPI Number Information
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NPI Number | 1902604358
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Entity Type | Organization
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Legal Business Name | HEALTH & WHOLENESS CENTER LLC
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 3510 S KEYSTONE AVE STE B
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-3594
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Country | US
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Telephone | 317-444-8466
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Fax |
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Provider Business Mailing Address
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Address Line | 6727 EVERGLADES CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46217-3920
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Country | US
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Telephone | 480-603-7650
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER L STAUTH
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Credential |
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Telephone | 480-603-7650
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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 |
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