Provider Demographics
NPI:1437780269
Name:HEALTHCARE 360 PLLC
Entity Type:Organization
Organization Name:HEALTHCARE 360 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:681-318-3477
Mailing Address - Street 1:9016 SENECA TRAIL
Mailing Address - Street 2:
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970-8375
Mailing Address - Country:US
Mailing Address - Phone:681-318-3477
Mailing Address - Fax:681-318-3479
Practice Address - Street 1:9016 SENECA TRAIL
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-8375
Practice Address - Country:US
Practice Address - Phone:681-318-3477
Practice Address - Fax:681-318-3479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty