MEDICARE: ELECTROMED WELLNESS GROUP INCORPORATED

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	208VP0000X	Pain Medicine Physician		OH

General Provider Information

NPI Number	:	1356571483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELECTROMED WELLNESS GROUP INCORPORATED

Provider Business Mailing Address
First Line	:	6100 OAK TREE BLVD
Second Line	:	SUITE 200, PMB 2124
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2544
Country	:	US
Telephone Number	:	440-212-6205
Fax Number	:

Provider Business Practice Location Address
First Line	:	6100 OAK TREE BLVD
Second Line	:	SUITE 200, PMB 2124
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2544
Country	:	US
Telephone Number	:	440-212-6205
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. KATHY MERHOLZ
Credential	:
Telephone Number	:	440-212-6205

Provider Enumeration Date	:	07/23/2009
Last Update Date	:	07/23/2009

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