Provider Demographics
NPI:1629493424
Name:MAXIMUM HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:MAXIMUM HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-791-4205
Mailing Address - Street 1:6094 APPLE TREE DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-0308
Mailing Address - Country:US
Mailing Address - Phone:901-791-4205
Mailing Address - Fax:901-791-4157
Practice Address - Street 1:6094 APPLE TREE DR
Practice Address - Street 2:SUITE 6
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-0308
Practice Address - Country:US
Practice Address - Phone:901-791-4205
Practice Address - Fax:901-791-4157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44185208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN44185OtherSTATE LICENSE