360 Wellness Clinic LLC
Clinic/Center in Benton, AR. Organization (NPI-2).
NPI number1366048803
StatusActive
Last updated in NPPESMay 9, 2022
Details
- NPI
- 1366048803
- Entity type
- Organization (NPI-2)
- Legal business name
- 360 Wellness Clinic LLC
- Organization subpart
- No
- Enumeration date
- Dec 9, 2020
- Certification date
- May 9, 2022
- Last updated
- May 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 261QR1300X | Clinic/Center, Rural Health | – | – |
Other names
- The Shot Clinic (Doing Business As)
- West Side Wellness (Doing Business As)
Practice location
620 W South St Ste ABenton, AR 72015-4235
Phone 501-794-6123 · Fax 501-794-6148
Mailing address
620 W South St Ste ABenton, AR 72015-4235
Phone 501-794-6123
Authorized official
Blake Torres
Owner
5017783151
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Clinic/Center providers in Benton, AR
- Amayszn LLCNPI 1467232579
- Arkansas Healing Space, PLLCNPI 1841087111
- Arkansas Mobile Wound Management PLLCNPI 1871348441
- Ascent Childrens Heath ServicesNPI 1053448233
- Bhc Pinnacle Pointe Hospital, INC.NPI 1710259437
- Congo Dental, PLLCNPI 1295423192
- Core Empowerment Group LLCNPI 1962631523
- Crutchfield House LLCNPI 1215498464
- Elite Spine & Joint, PLLCNPI 1699201376
- Experience Counseling Clinic, INC.NPI 1053198283
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.