NPI | 1174339337 |
---|---|
Doing Business As | SOUTHSIDE WELLNESS CLINIC |
Entity Type | Organization |
Authorized Contact | TRICIA SUBLET Director Of Services 785-821-4094 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 207Q00000X Family Medicine |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
261QC1500X Clinic/Center, Community Health | |
Enumeration Date | 2024-12-03 |
Last Update Date | 2025-08-20 |