Provider Demographics
NPI:1538462015
Name:SUPERIOR HEALTH AND WELLNESS INC.
Entity Type:Organization
Organization Name:SUPERIOR HEALTH AND WELLNESS INC.
Other - Org Name:BLUFFTON HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-247-3054
Mailing Address - Street 1:163 BLUFFTON RD STE D
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-6226
Mailing Address - Country:US
Mailing Address - Phone:843-247-3054
Mailing Address - Fax:
Practice Address - Street 1:163 BLUFFTON RD STE D
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-6226
Practice Address - Country:US
Practice Address - Phone:843-247-3054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty