| NPI | 1134531395 |
|---|---|
| Former Legal Business Name | TOTAL HEALTH AND WELLNESS, INC. |
| Doing Business As | HEALTHSOURCE OF BUFFALO |
| Entity Type | Organization |
| Authorized Contact | KRISTIN LYNN KRUGER Owner 763-600-8355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: MN 5468) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2024-08-14 |