Advanced Wellness Group Inc

NPI 1003099235 - Medical Genetics, Ph.D. Medical Genetics - 170100000X

NPI Details
NPI 1003099235
Enumeration Date 12/11/2007
Last Updated 10/17/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KENNETH RONALD KENNETH
Position SUPERVISING PHYSICIAN
Phone (903) 447-5470
Fax
Practice Location
2705 E QUINLAN PKWY
QUINLAN TX, 75474-8688, US
Phone (903) 447-5470
Fax
Business Location
PO BOX 789
QUINLAN TX, 75474-0014, US
Phone (903) 447-5470
Fax
Toxanomy
Taxonomy Code 170100000X
License State Texas
License Number K0722
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According to our database, Advanced Wellness Group Inc NPI is 1003099235, taxonomy code is 170100000X and license number is K0722, license state is located at Texas. Advanced Wellness Group Inc physically located at 2705 E Quinlan Pkwy, Quinlan TX, 75474-8688. NPI Number 1033115704 has the healthcare provider type.

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1003099235 NPI number is provided on an as is basis without warranty of any kind. 1003099235 is maintained by the National Plan & Provider Enumeration System. The contents of Advanced Wellness Group Inc are for informational purposes only.