Provider Demographics
NPI:1972135796
Name:WELLNESS FOR ANY BODY LLC
Entity Type:Organization
Organization Name:WELLNESS FOR ANY BODY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMBO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:402-578-0670
Mailing Address - Street 1:4045 GREBE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68112-1975
Mailing Address - Country:US
Mailing Address - Phone:402-578-0670
Mailing Address - Fax:315-750-3415
Practice Address - Street 1:14440 F ST STE 121
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1005
Practice Address - Country:US
Practice Address - Phone:402-578-0670
Practice Address - Fax:315-750-3415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center