Provider Demographics
NPI:1932565900
Name:WELLOSOPHY
Entity Type:Organization
Organization Name:WELLOSOPHY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PERSONAL TRAINER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DUPLESSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-975-8487
Mailing Address - Street 1:703 GARDENIA CIR APT 4
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-4609
Mailing Address - Country:US
Mailing Address - Phone:805-975-8487
Mailing Address - Fax:
Practice Address - Street 1:703 GARDENIA CIR APT 4
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-4609
Practice Address - Country:US
Practice Address - Phone:805-975-8487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACI# 854-7251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare