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 | 2025-01-07 |