| NPI | 1467225730 |
|---|---|
| Doing Business As | WOLFPACK WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | CAROLYN KAY DAUGHERTY Assistant Dean 719-549-2830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |