| NPI | 1902415078 |
|---|---|
| Other Name | MODERN HEALTH & WELLNESS |
| Former Legal Business Name | MODERN HEALTH & WELLNESS LLC |
| Entity Type | Organization |
| Authorized Contact | KETRINA E LEWIS Nurse Practitioner 469-659-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-07-24 |