21st Century Total Wellness, Llc

NPI 1043412711 - Specialist - 174400000X

NPI Details
NPI 1043412711
Enumeration Date 06/04/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name EDGAR DANIEL EDGAR
Position RESIDENT AGENT
Phone (219) 345-3892
Fax
Practice Location
5522 E 989 N
DEMOTTE IN, 46310-8016, US
Phone (219) 345-3892
Fax
Business Location
5522 E 989 N
DEMOTTE IN, 46310-8016, US
Phone (219) 345-3892
Fax
Toxanomy
Taxonomy Code 174400000X
License State
License Number
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According to our database, 21st Century Total Wellness, Llc NPI is 1043412711, taxonomy code is 174400000X 21st Century Total Wellness, Llc physically located at 5522 E 989 N, Demotte IN, 46310-8016. NPI Number 1033115704 has the healthcare provider type.

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1043412711 NPI number is provided on an as is basis without warranty of any kind. 1043412711 is maintained by the National Plan & Provider Enumeration System. The contents of 21st Century Total Wellness, Llc are for informational purposes only.