# CLINTON WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1386826279
- **Authorized official:** TRICIA B DUNCAN BILLER (MEDICAL BILLER)
- **Authorized official phone:** (601) 878-6945

## Contact information

- **Practice address:** 703 HIGHWAY 80 W STE A, CLINTON, MS 39056-4107
- **Practice address phone:** (601) 488-6187
- **Practice address fax:** (601) 878-2011
- **Mailing address:** PO BOX 1338, CLINTON, MS 39060-1338
- **Mailing address phone:** (601) 488-6187
- **Mailing address fax:** (601) 878-2011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 18239 | MS | Yes |

## Other

- **Enumeration date:** 12/03/2007
- **Last updated:** 01/02/2009