NPI | 1134826712 |
---|---|
Doing Business As | AMAZING VICTORY HEALTH AND WELLNESS LLC |
Entity Type | Organization |
Authorized Contact | STEPHANIE LAROSE CEO 475-500-2334 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Enumeration Date | 2023-02-14 |
Last Update Date | 2023-02-14 |