Provider Demographics
NPI:1568870038
Name:NATURAL HEALTH AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:NATURAL HEALTH AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-843-6781
Mailing Address - Street 1:2424 AIRWAY DR STE B
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-7125
Mailing Address - Country:US
Mailing Address - Phone:270-843-6781
Mailing Address - Fax:270-746-0204
Practice Address - Street 1:2424 AIRWAY DR STE B
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-7125
Practice Address - Country:US
Practice Address - Phone:270-843-6781
Practice Address - Fax:270-746-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4859111N00000X
KY1093908364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty