MEDICARE: FAMILY WHOLISTIC WELLNESS

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	175F00000X	Naturopath	2006008065
2	225700000X	Massage Therapist	2006008065	MO

General Provider Information

NPI Number	:	1477919264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY WHOLISTIC WELLNESS

Provider Business Mailing Address
First Line	:	3021 HIGHWAY A
Second Line	:
City	:	WASHINGTON
State	:	MO
Zip	:	63090-5498
Country	:	US
Telephone Number	:	636-432-5567
Fax Number	:	636-432-5567

Provider Business Practice Location Address
First Line	:	3021 HIGHWAY A
Second Line	:
City	:	WASHINGTON
State	:	MO
Zip	:	63090-5498
Country	:	US
Telephone Number	:	636-432-5567
Fax Number	:	636-432-5567

Authorized Official
Title or Position	:	NATUROPATH
Name	:	DR. DAWN M CAHILL
Credential	:
Telephone Number	:	636-432-5567

Provider Enumeration Date	:	01/08/2016
Last Update Date	:	01/08/2016

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Directions to “FAMILY WHOLISTIC WELLNESS ” Practice Location

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