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General NPI Number Information
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NPI Number | 1932537230
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Entity Type | Organization
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Legal Business Name | HORMONE HEALTH AND WEIGHT LOSS
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 6202 N 9TH AVE SUITE 4
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City | PENSACOLA
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State | FL
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Zip | 32504-8293
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Country | US
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Telephone | 850-462-9561
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Fax | 850-462-9560
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Provider Business Mailing Address
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Address Line | 6202 N 9TH AVE SUITE 4
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City | PENSACOLA
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State | FL
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Zip | 32504-8293
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Country | US
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Telephone | 850-462-9561
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Fax | 850-462-9560
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Authorized Official
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Title or Position | OWNER
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Name | ERIC SCOTT CHASTAIN
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Credential |
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Telephone | 850-462-9561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | AL
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