Organization Name: | KOLBE CLINIC LLC |
NPI Number: | 1841675865 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM CARL WAINSCOTT (CEO) |
Mailing Address: | 109 Foothills Pkwy Suite 113 Chelsea |
State: | AL US |
Postal Code: | 350438235 |
Phone Number: | 2056189899 |
Fax Number: | 2056189706 |
NPI Enumeration Date: | 07/21/2015 |
NPI Last Update Date: | 11/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD.21506 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |