Wise Roots Wellness, Llc

NPI 1023350063 - Social Worker - 1041C0700X

NPI Details
NPI 1023350063
Enumeration Date 03/16/2013
Last Updated 03/16/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name VIRGINIA WYATT VIRGINIA
Position OWNER
Phone (312) 445-8906
Fax
Practice Location
3600 W WRIGHTWOOD AVE
CHICAGO IL, 60647-1138, US
Phone (312) 445-8906
Fax
Business Location
2619 W ATTRILL ST
CHICAGO IL, 60647-4003, US
Phone
Fax
Toxanomy
Taxonomy Code 1041C0700X
License State Illinois
License Number 149015015
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According to our database, Wise Roots Wellness, Llc NPI is 1023350063, taxonomy code is 1041C0700X and license number is 149015015, license state is located at Illinois. Wise Roots Wellness, Llc physically located at 3600 W Wrightwood Ave, Chicago IL, 60647-1138. NPI Number 1033115704 has the healthcare provider type.

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1023350063 NPI number is provided on an as is basis without warranty of any kind. 1023350063 is maintained by the National Plan & Provider Enumeration System. The contents of Wise Roots Wellness, Llc are for informational purposes only.