Provider Demographics
NPI:1801570056
Name:WELL ONE COLLECTIVE
Entity type:Organization
Organization Name:WELL ONE COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-522-7540
Mailing Address - Street 1:114 BRADY CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4554
Mailing Address - Country:US
Mailing Address - Phone:207-522-7540
Mailing Address - Fax:
Practice Address - Street 1:114 BRADY CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4554
Practice Address - Country:US
Practice Address - Phone:207-522-7540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty