| NPI | 1306214606 |
|---|---|
| Doing Business As | HEALTH SOURCE WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | RAYMOND DI IULIO Managing Member 754-264-7540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2017-07-24 |