Organization · Type 2 NPI

360 Wellness Clinic LLC

Clinic/Center · Benton, AR

NPI number 1366048803 Active

Practice location

620 W South St Ste A
Benton, AR 72015-4235

Fax (501) 794-6148

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed
Rural Health Clinic/Center	261QR1300X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Other clinic/center providers in Benton

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NPI record

NPI: 1366048803
Entity type: Organization (Type 2)
Issued: Dec 9, 2020
Last updated: May 9, 2022
Status: Active

Other names

<unavail>
The Shot Clinic · doing business as
West Side Wellness · doing business as
West Side Wellness · doing business as

Authorized official

Blake Torres
Owner
(501) 778-3151

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1366048803

360 Wellness Clinic LLC's National Provider Identifier is 1366048803, issued on Dec 9, 2020. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Benton, AR. The record was last updated on May 9, 2022.