| NPI | 1851072037 |
|---|---|
| Doing Business As | FUNCTIONAL MEDICINE AND WELLNESS, PC |
| Entity Type | Organization |
| Authorized Contact | LISA MARIE CAMPANELLA-COPPO Owner 551-316-7740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |