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General NPI Number Information
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NPI Number | 1992303010
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Entity Type | Organization
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Legal Business Name | NORTHWEST HEALTH AND WELLNESS, INC
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 215 NORTHWEST DRIVE
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City | SENATOBIA
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State | MS
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Zip | 38668
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Country | US
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Telephone | 662-473-1667
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Fax |
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Provider Business Mailing Address
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Address Line | 50 S MAIN ST
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City | WATER VALLEY
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State | MS
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Zip | 38965-2946
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Country | US
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Telephone | 662-473-1667
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CHRIS R WILKINSON
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Credential |
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Telephone | 662-473-1667
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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 |
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