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Organization
BEYOUTIFUL WELLNESS CLINIC & RAPID LABS LLC
Active
Organization
BEYOUTIFUL WELLNESS CLINIC & RAPID LABS LLC
Active
Other names
BEYOUTIFUL WELLNESS CLINIC & RAPID LABS LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA RIDEOUT (CEO)
(601) 441-2481
Entity
Organization
Contact information
Practice address
4900 OLD HIGHWAY 11 STE 4, HATTIESBURG, MS 39402-8656
(601) 441-9846
Mailing address
1661 DAWSEY DR, COLUMBIA, MS 39429-7736
(601) 441-2481
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
171400000X
Health & Wellness Coach
Primary
—
NULL
171400000X
Health & Wellness Coach
Primary
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
NULL
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
246RM2200X
Medical Laboratory Technician
—
NULL
246RM2200X
Medical Laboratory Technician
—
—
363AM0700X
Medical Physician Assistant
—
NULL
Other
Enumeration date
02/22/2024
Last updated
02/22/2024
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