Organization · NPI-2

180 Health Lifestyle Wellness Centers

General Practice · Springfield, MO

NPI number1649815796
StatusActive
Last updated in NPPESJul 28, 2020

Details

NPI
1649815796
Entity type
Organization (NPI-2)
Legal business name
180 Health Lifestyle Wellness Centers
Organization subpart
No
Enumeration date
Nov 13, 2019
Certification date
Jul 28, 2020
Last updated
Jul 28, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General Practice––Yes
207Q00000X Family Medicine––

Other names

  • 180 Health Medical And Wellness Center (Doing Business As)

Practice location

1936 S Glenstone Ave
Springfield, MO 65804-2305

Phone 417-827-0450

Mailing address

1936 S Glenstone Ave
Springfield, MO 65804-2305

Phone 417-827-0450

Authorized official

Tara Meek
Owner
4178870340

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