Provider Demographics
NPI:1407588114
Name:ONE TO ONE HEALTH
Entity Type:Organization
Organization Name:ONE TO ONE HEALTH
Other - Org Name:THE CENTER FOR HEALTHY LIVING AT PNW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF CLIENT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-727-9148
Mailing Address - Street 1:1067 RIVERFRONT PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-2222
Mailing Address - Country:US
Mailing Address - Phone:423-902-9530
Mailing Address - Fax:
Practice Address - Street 1:2250 173RD ST
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46323-2074
Practice Address - Country:US
Practice Address - Phone:765-494-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONE TO ONE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-30
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center