| NPI | 1427540806 |
|---|---|
| Doing Business As | ADVANCED WELLNESS |
| Entity Type | Organization |
| Authorized Contact | ROXANNE W. WHEELER Credentialing Specialist 936-579-3931 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-09-17 |