| NPI | 1952083495 |
|---|---|
| Doing Business As | HERITAGE WELLNESS CENTER, LLC |
| Entity Type | Organization |
| Authorized Contact | CLAUDETTE MICHELLE MALLORY Nurse Practitioner 904-259-0092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2023-08-03 |