MEDICARE: MEIZA 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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1932893328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEIZA WELLNESS

Provider Business Mailing Address
First Line	:	1847 SATTERWHITE ST
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-1937
Country	:	US
Telephone Number	:	205-382-2495
Fax Number	:

Provider Business Practice Location Address
First Line	:	1847 SATTERWHITE ST
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-1937
Country	:	US
Telephone Number	:	205-382-2495
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JALEN GRAVES
Credential	:
Telephone Number	:	205-382-2495

Provider Enumeration Date	:	06/07/2023
Last Update Date	:	06/07/2023

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Directions to “MEIZA WELLNESS ” Practice Location

Language	Start Address	Practice Location

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