NPI | 1912731712 |
---|---|
Doing Business As | LEGACY WELLNESS PLLC |
Entity Type | Organization |
Authorized Contact | KRISTIN KELLY Provider 623-792-3584 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2024-08-26 |
Last Update Date | 2024-08-26 |