| NPI | 1851100432 |
|---|---|
| Doing Business As | TEQUILA'S WHOLE HEALTH, LLC |
| Entity Type | Organization |
| Authorized Contact | TEQUILA MARIE ROGERS Owner 304-573-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-01-07 |
| Last Update Date | 2025-10-29 |