Provider Demographics
NPI:1821221268
Name:INGLIS WELLNESS CLINIC PLLC
Entity type:Organization
Organization Name:INGLIS WELLNESS CLINIC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:INGLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-733-5268
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-0610
Mailing Address - Country:US
Mailing Address - Phone:518-733-5268
Mailing Address - Fax:518-733-5269
Practice Address - Street 1:168 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1618
Practice Address - Country:US
Practice Address - Phone:518-733-5268
Practice Address - Fax:518-733-5269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty