Provider Demographics
NPI:1922566876
Name:GLOBAL WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:GLOBAL WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YASSIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-588-9830
Mailing Address - Street 1:2525 TILLER LN STE 107
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2267
Mailing Address - Country:US
Mailing Address - Phone:614-588-9830
Mailing Address - Fax:
Practice Address - Street 1:3350 CLEVELAND AVE STE 1964
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3677
Practice Address - Country:US
Practice Address - Phone:614-588-9830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty