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NPI Code Detail

MEDICARE: APPELLO HEALTH AND WELLNESS CLINIC, LLC

MEDICARE: APPELLO HEALTH AND WELLNESS CLINIC, LLC
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
1261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1215773262
Entity Type Code : Organization
Provider Name (Legal Business Name) : APPELLO HEALTH AND WELLNESS CLINIC, LLC
Provider Business Mailing Address
First Line : 500 PRESIDENT CLINTON AVE STE 200-F
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72201-1756
Country : US
Telephone Number : 501-772-7518
Fax Number :
Provider Business Practice Location Address
First Line : 2223 GRANT ST
Second Line :
City : MALVERN
State : AR
Zip : 72104-4700
Country : US
Telephone Number : 501-337-9031
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : JASON WAYNE LEE
Credential :
Telephone Number : 501-772-7518
Provider Enumeration Date : 07/08/2024
Last Update Date : 02/10/2025

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Directions to “APPELLO HEALTH AND WELLNESS CLINIC, LLC ” Practice Location

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