# REBEL WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Balanced Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568157139
- **Authorized official:** DR. JENNIFER O'DONNELL FNP-C (MEMBER)
- **Authorized official phone:** (314) 238-4101

## Contact information

- **Practice address:** 1000 N TRUMAN BLVD STE C, CRYSTAL CITY, MO 63019-1311
- **Practice address phone:** (636) 638-1017
- **Mailing address:** 1000 N TRUMAN BLVD STE C, CRYSTAL CITY, MO 63019-1311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/10/2023
- **Last updated:** 04/10/2023