830 Wellness, LLC
Clinic/Center, Primary Care in Kerrville, TX. Organization (NPI-2).
NPI number1649972043
StatusActive
Last updated in NPPESMar 20, 2023
Details
- NPI
- 1649972043
- Entity type
- Organization (NPI-2)
- Legal business name
- 830 Wellness, LLC
- Organization subpart
- No
- Enumeration date
- Mar 20, 2023
- Certification date
- Mar 16, 2023
- Last updated
- Mar 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Practice location
2210 Bandera Hwy Ste C-2Kerrville, TX 78028-6609
Phone 903-576-5677
Mailing address
477 Lariat TraceBandera, TX 78003
Authorized official
Lacy McMillon
Owner
9035765677
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