Provider Demographics
NPI:1073796041
Name:NATURAL HEALTH & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:NATURAL HEALTH & WELLNESS CENTER LLC
Other - Org Name:NATURAL HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-874-4333
Mailing Address - Street 1:2103 MAIN ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-6300
Mailing Address - Country:US
Mailing Address - Phone:203-874-4333
Mailing Address - Fax:203-878-1725
Practice Address - Street 1:2103 MAIN ST
Practice Address - Street 2:SUITE #2
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-6300
Practice Address - Country:US
Practice Address - Phone:203-874-4333
Practice Address - Fax:203-878-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000283175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty