Provider Demographics
NPI:1407534225
Name:WELLNESS CO.
Entity Type:Organization
Organization Name:WELLNESS CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-741-2364
Mailing Address - Street 1:400 S STATE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-2092
Mailing Address - Country:US
Mailing Address - Phone:616-741-2364
Mailing Address - Fax:616-741-2367
Practice Address - Street 1:400 S STATE ST STE 250
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-2092
Practice Address - Country:US
Practice Address - Phone:616-741-2364
Practice Address - Fax:616-741-2367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care