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General NPI Number Information
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NPI Number | 1952926982
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Entity Type | Organization
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Legal Business Name | WELLNOS PLLC
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Dates
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Enumeration Date | 06/16/2020
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 4490 N UNIVERSITY DR
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City | LAUDERHILL
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State | FL
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Zip | 33351-4513
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Country | US
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Telephone | 754-701-7274
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Fax | 954-453-6065
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Provider Business Mailing Address
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Address Line | 4490 N UNIVERSITY DR
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City | LAUDERHILL
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State | FL
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Zip | 33351-4513
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Country | US
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Telephone | 754-701-7274
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Fax | 954-453-6065
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD A HENRY
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Credential | DC
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Telephone | 754-701-7274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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