Wolf Pack LLC
Clinic/Center in Ammon, ID. Organization (NPI-2).
NPI number1992323216
StatusActive
Last updated in NPPESJul 13, 2020
Details
- NPI
- 1992323216
- Entity type
- Organization (NPI-2)
- Legal business name
- Wolf Pack LLC
- Organization subpart
- No
- Enumeration date
- Jul 13, 2020
- Certification date
- Jul 13, 2020
- Last updated
- Jul 13, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- Ahhhsome Relaxation (Doing Business As)
Practice location
939 S 25th E Ste 115Ammon, ID 83406-5736
Phone 208-523-1209
Mailing address
939 S 25th E Ste 115Ammon, ID 83406-5736
Phone 208-523-1209
Authorized official
Shawn Tolman
Ceo
2083131089
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