Provider Demographics
NPI:1598535890
Name:WELLAGAIN HAND AND FOOT CLINIC, LLC
Entity Type:Organization
Organization Name:WELLAGAIN HAND AND FOOT CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-341-8831
Mailing Address - Street 1:20180680 PO BOX 798
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66601
Mailing Address - Country:US
Mailing Address - Phone:785-341-8831
Mailing Address - Fax:
Practice Address - Street 1:7530 TROOST AVE STE 102
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-5100
Practice Address - Country:US
Practice Address - Phone:913-608-9127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center