| NPI | 1427710896 |
|---|---|
| Doing Business As | SOUTHERN LUX AND METABOLIC WELLNESS |
| Entity Type | Organization |
| Authorized Contact | KELLEY E BLAKE Nurse Practitioner 719-661-6033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2025-02-20 |