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Organization
DIABETES AND WELLNESS CLINIC OF THE SHOALS
Active
Organization
DIABETES AND WELLNESS CLINIC OF THE SHOALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THADDEUS JASON BOUGHTON CRNP (OWNER)
(256) 856-4059
Entity
Organization
Contact information
Practice address
1110 E 6TH ST SUITE E, MUSCLE SHOALS, AL 35661
(256) 856-4059
Mailing address
114 CHAPPELL RD, MUSCLE SHOALS, AL 35661-3650
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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