# WELLNESS FAMILY PRACTICE INC

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

## Provider details

- **NPI number:** 1174921126
- **Authorized official:** DR. KELLY HENSGEN D,I, (OWNER)
- **Authorized official phone:** (386) 615-3500

## Contact information

- **Practice address:** 500 MEMORIAL CIR STE C, ORMOND BEACH, FL 32174-5054
- **Practice address phone:** (386) 615-3500
- **Practice address fax:** (386) 615-3505
- **Mailing address:** 500 MEMORIAL CIR STE C, ORMOND BEACH, FL 32174-5054
- **Mailing address phone:** (386) 615-3500
- **Mailing address fax:** (386) 615-3505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2014
- **Last updated:** 03/12/2015