Organization Name: | INTERNATIONAL CENTER FOR HEALTH & WELLNESS LLC |
NPI Number: | 1437328341 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALAN W GRUNING (PRESIDENT) |
Mailing Address: | 3677 Central Ave Suite E Fort Myers |
State: | FL US |
Postal Code: | 339018226 |
Phone Number: | 2399393303 |
Fax Number: | 2399397373 |
NPI Enumeration Date: | 02/25/2008 |
NPI Last Update Date: | 03/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS5181 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |