Provider Demographics
NPI:1053814723
Name:WOMB TO TOMB WELLNESS
Entity Type:Organization
Organization Name:WOMB TO TOMB WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ESTEP
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:608-571-4007
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-0303
Mailing Address - Country:US
Mailing Address - Phone:608-571-4007
Mailing Address - Fax:
Practice Address - Street 1:525 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-1730
Practice Address - Country:US
Practice Address - Phone:608-571-4007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty