Provider Demographics
NPI:1366834715
Name:PELLA SLEEP & WELLNESS INC
Entity Type:Organization
Organization Name:PELLA SLEEP & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:START
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-450-0247
Mailing Address - Street 1:2407 DRENTHE LAAN
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-7875
Mailing Address - Country:US
Mailing Address - Phone:814-450-0247
Mailing Address - Fax:
Practice Address - Street 1:2607 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-7924
Practice Address - Country:US
Practice Address - Phone:814-450-0247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic