Provider Demographics
NPI:1508587742
Name:NATURAL WELLNESS LAB
Entity Type:Organization
Organization Name:NATURAL WELLNESS LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEMBOTOMIST
Authorized Official - Phone:205-200-1785
Mailing Address - Street 1:833 ALLISON BONNETT MEMORIAL DR STE 151
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35023-1884
Mailing Address - Country:US
Mailing Address - Phone:480-791-6233
Mailing Address - Fax:877-775-2515
Practice Address - Street 1:833 ALLISON BONNETT MEMORIAL DR STE 151
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35023-1884
Practice Address - Country:US
Practice Address - Phone:480-791-6233
Practice Address - Fax:877-775-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty