MEDICARE: THE WELLNESS SPECTRUM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1134887995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WELLNESS SPECTRUM

Provider Business Mailing Address
First Line	:	2800 HEATHSTEAD PL APT H
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-7155
Country	:	US
Telephone Number	:	120-221-3329
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 HEATHSTEAD PL APT H
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-7155
Country	:	US
Telephone Number	:	202-213-3292
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PAMELA HANDON
Credential	:
Telephone Number	:	202-213-3292

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	11/29/2021

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Directions to “THE WELLNESS SPECTRUM ” Practice Location

Language	Start Address	Practice Location

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