Provider Demographics
NPI:1891280541
Name:WELLNESS HEALTH GROUP, LLC
Entity Type:Organization
Organization Name:WELLNESS HEALTH GROUP, LLC
Other - Org Name:ATTIS FEDERAL LABS, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUDERMILK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-310-2200
Mailing Address - Street 1:7780 E 106TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6843
Mailing Address - Country:US
Mailing Address - Phone:918-310-2200
Mailing Address - Fax:918-310-2201
Practice Address - Street 1:7780 E 106TH ST STE 205
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6843
Practice Address - Country:US
Practice Address - Phone:918-310-2200
Practice Address - Fax:918-310-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory