Provider Demographics
NPI:1023221496
Name:WOMEN'S WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:WOMEN'S WELLNESS CENTER, INC.
Other - Org Name:THE CENTER FOR MATERNAL-FETAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-449-9355
Mailing Address - Street 1:1705 E. BROADWAY, SUITE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5852
Mailing Address - Country:US
Mailing Address - Phone:573-449-9355
Mailing Address - Fax:573-441-9355
Practice Address - Street 1:1705 E. BROADWAY, SUITE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5852
Practice Address - Country:US
Practice Address - Phone:573-449-9355
Practice Address - Fax:573-441-9355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty