# SOUTHERN KETAMINE AND WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104611722
- **Authorized official:** JOHN HARRISON IRONS MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (205) 379-6075

## Contact information

- **Practice address:** 2200 GATEWAY DR STE AA, OPELIKA, AL 36801-6884
- **Practice address phone:** (334) 209-5340
- **Mailing address:** 1932 LAUREL RD STE 1B, VESTAVIA HILLS, AL 35216-1939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/14/2025
- **Last updated:** 04/14/2025