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Organization
PURE INTEGRATIVE WELLNESS AND HYDRATION LLC
Active
Organization
PURE INTEGRATIVE WELLNESS AND HYDRATION LLC
Active
Other names
Pure Integrative Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA GABRIELLE SMITH (BUSINESS MANAGER)
(601) 490-1723
Entity
Organization
Contact information
Practice address
2703 UNIVERSITY BLVD E STE B, TUSCALOOSA, AL 35404-3226
(205) 248-7064
(205) 523-7158
Mailing address
2703 UNIVERSITY BLVD E STE B, TUSCALOOSA, AL 35404-3226
(205) 248-7064
(888) 501-7784
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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