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Organization
WELL INFUSED, LLC
Active
Organization
WELL INFUSED, LLC
Active
Parent organization
LEGACY IMPACT HOLDINGS, LLC
Other names
Well Infused
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEGACY IMPACT HOLDINGS, LLC
Authorized official
DR. STACI J BLUME DC (OWNER / PARTNER)
(317) 674-8857
Entity
Organization
Contact information
Practice address
14297 BERGEN BLVD STE 125, NOBLESVILLE, IN 46060-3420
(317) 674-8857
Mailing address
14297 BERGEN BLVD STE 125, NOBLESVILLE, IN 46060-3420
(317) 674-8857
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
NULL
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/11/2022
Last updated
10/17/2022
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