Provider Demographics
NPI:1619710696
Name:BLISS HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:BLISS HEALTH AND WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:662-825-0987
Mailing Address - Street 1:905 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-1908
Mailing Address - Country:US
Mailing Address - Phone:662-825-0987
Mailing Address - Fax:
Practice Address - Street 1:203 5TH AVE S
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-4216
Practice Address - Country:US
Practice Address - Phone:662-825-0987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty