Provider Demographics
NPI:1508433145
Name:SIGNATURE WELLNESS CENTER BELLEVILLE LLC
Entity Type:Organization
Organization Name:SIGNATURE WELLNESS CENTER BELLEVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING REPRESENTATIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-683-3855
Mailing Address - Street 1:471 CORTLANDT ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3330
Mailing Address - Country:US
Mailing Address - Phone:973-759-2222
Mailing Address - Fax:973-759-2226
Practice Address - Street 1:471 CORTLANDT ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3330
Practice Address - Country:US
Practice Address - Phone:973-759-2222
Practice Address - Fax:973-759-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty