Provider Demographics
NPI:1407268659
Name:KEY POINTE MEDICAL WEIGHT LOSS & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:KEY POINTE MEDICAL WEIGHT LOSS & WELLNESS CENTER LLC
Other - Org Name:YOUR WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVETT
Authorized Official - Suffix:
Authorized Official - Credentials:MMD
Authorized Official - Phone:937-743-9474
Mailing Address - Street 1:235 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-4429
Mailing Address - Country:US
Mailing Address - Phone:937-743-9474
Mailing Address - Fax:937-743-9475
Practice Address - Street 1:7770 COOPER RD
Practice Address - Street 2:SUITE 8
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-7744
Practice Address - Country:US
Practice Address - Phone:513-791-9474
Practice Address - Fax:513-791-9475
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEY POINTE MEDICAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35058433261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty