Provider Demographics
NPI:1275090557
Name:WELLNESS IN YOU, LLC
Entity Type:Organization
Organization Name:WELLNESS IN YOU, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, FNP-BC
Authorized Official - Phone:563-340-3989
Mailing Address - Street 1:23580 220TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-9428
Mailing Address - Country:US
Mailing Address - Phone:563-340-3989
Mailing Address - Fax:563-726-7000
Practice Address - Street 1:23580 220TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-9428
Practice Address - Country:US
Practice Address - Phone:563-340-3989
Practice Address - Fax:563-726-7000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service