Provider Demographics
NPI:1326403049
Name:SYNERGY WELLNESS, LLC
Entity Type:Organization
Organization Name:SYNERGY WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:614-218-6007
Mailing Address - Street 1:470 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9364
Mailing Address - Country:US
Mailing Address - Phone:614-218-6007
Mailing Address - Fax:
Practice Address - Street 1:2939 KENNY RD
Practice Address - Street 2:SUITE 195
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2406
Practice Address - Country:US
Practice Address - Phone:614-218-6007
Practice Address - Fax:614-920-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD5254136A00000X
OHLD5347136A00000X
OH65.000279171100000X
OH65.000303171100000X
OH33.007725225700000X
OH33.005880225700000X
OH33.013924225700000X
OH33.015418225700000X
OH33.016055225700000X
OH33.016869225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No136A00000XDietary & Nutritional Service ProvidersDietetic Technician, RegisteredGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty