Organization · Type 2 NPI
St. Johns Wellness Center, LLC
Specialist · St. Augustine, FL
NPI number
1710152897
Active
Practice location
305 Kingsley Lake Dr, Suite 702
St. Augustine, FL 32092-3043
Mailing address
4361 Comanche Trail Blvd
St. Johns, FL 32259-4285
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | MM18687 (FL) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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About NPI 1710152897
St. Johns Wellness Center, LLC's National Provider Identifier is 1710152897, issued on Apr 29, 2008. The primary taxonomy on file is Specialist (174400000X), and the practice location is in St. Augustine, FL. The record was last updated on Apr 29, 2008.