NPI | 1053880518 |
---|---|
Doing Business As | PHYSICIAN WELLNESS PROFESSIONAL ASSOCIATION |
Entity Type | Organization |
Authorized Contact | WILLIAM G REILLY Authorized Official 817-410-3800 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Enumeration Date | 2018-11-14 |
Last Update Date | 2018-11-14 |