Provider Demographics
NPI:1467272823
Name:SUMMIT HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:SUMMIT HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-266-9831
Mailing Address - Street 1:97 ST CLAIR DR
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:TN
Mailing Address - Zip Code:37327-6063
Mailing Address - Country:US
Mailing Address - Phone:423-949-7990
Mailing Address - Fax:423-949-7999
Practice Address - Street 1:97 ST CLAIR DR
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:TN
Practice Address - Zip Code:37327-6063
Practice Address - Country:US
Practice Address - Phone:423-949-7990
Practice Address - Fax:423-949-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty