Provider Demographics
NPI:1760093215
Name:SHRIVERS WELLNESS SOLUTIONS LTD
Entity Type:Organization
Organization Name:SHRIVERS WELLNESS SOLUTIONS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HOLTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-508-0213
Mailing Address - Street 1:310 W UNION ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2312
Mailing Address - Country:US
Mailing Address - Phone:740-447-9713
Mailing Address - Fax:740-447-9205
Practice Address - Street 1:310 W UNION ST STE 101
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2312
Practice Address - Country:US
Practice Address - Phone:740-447-9713
Practice Address - Fax:740-447-9205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty