| Organization Name: | WELLNESS CLINICAL GROUP PSC |
| NPI Number: | 1508287103 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOEL O LOPEZ (PRESIDENT) |
| Mailing Address: | 31 Calle San Benito Las Marias |
| State: | PR US |
| Postal Code: | 006702103 |
| Phone Number: | 7878270285 |
| Fax Number: | |
| NPI Enumeration Date: | 12/27/2013 |
| NPI Last Update Date: | 12/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 16683 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |