# HEALTHWISE WELLNESS LLC

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

## Provider details

- **NPI number:** 1184296162
- **Authorized official:** DR. TOCHI AMAGWULA MD (OWNER)
- **Authorized official phone:** (870) 454-4354

## Contact information

- **Practice address:** 4014 OLD WARREN RD, PINE BLUFF, AR 71603-6110
- **Practice address phone:** (870) 454-4354
- **Practice address fax:** (870) 390-4781
- **Mailing address:** 4014 OLD WARREN RD, PINE BLUFF, AR 71603-6110
- **Mailing address phone:** (870) 454-4354
- **Mailing address fax:** (870) 390-4781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VX0000X | Obstetrics Physician | — | NULL | — |
| 207VX0000X | Obstetrics Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/11/2021
- **Last updated:** 07/20/2021