Lifelong Wellness Center Inc

NPI 1043413487 - Family Medicine - 207Q00000X

NPI Details
NPI 1043413487
Enumeration Date 06/05/2007
Last Updated 10/18/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name EDITH-ELAINE HAMILL EDITH-ELAINE
Position PRESIDENT
Phone (918) 458-0700
Fax (918) 458-0424
Practice Location
1203 E ROSS BYP STE C
TAHLEQUAH OK, 74464-4188, US
Phone (918) 458-0700
Fax (918) 458-0424
Business Location
1203 E ROSS BYPASS
C
TAHLEQUAH OK, 74464-4188, US
Phone (918) 453-8550
Fax (918) 456-1096
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Lifelong Wellness Center Inc NPI is 1043413487, taxonomy code is 207Q00000X Lifelong Wellness Center Inc physically located at 1203 E Ross Byp Ste C, Tahlequah OK, 74464-4188. NPI Number 1033115704 has the healthcare provider type.

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1043413487 NPI number is provided on an as is basis without warranty of any kind. 1043413487 is maintained by the National Plan & Provider Enumeration System. The contents of Lifelong Wellness Center Inc are for informational purposes only.