| NPI | 1356716856 |
|---|---|
| Other Name | WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | BRENDA ROSENBAUGH L ROSENBAUGH Senior Medical Billing Specialist 757-716-2065 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2016-02-01 |