# WELLNESSCONNECT HEALTHCARE AND PREVENTIVE MEDICINE, LLC

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

## Provider details

- **NPI number:** 1699268672
- **Authorized official:** JACKIE COPELAND CPC (BILLING MANAGER/CREDENTIALING)
- **Authorized official phone:** (256) 907-2493

## Contact information

- **Practice address:** 2011 GALLATIN ST SW, HUNTSVILLE, AL 35801-4510
- **Practice address phone:** (256) 907-2493
- **Practice address fax:** (256) 281-8134
- **Mailing address:** 2011 GALLATIN ST SW, HUNTSVILLE, AL 35801-4510
- **Mailing address phone:** (256) 907-2493
- **Mailing address fax:** (256) 907-1726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 00013209 | AL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | MD13209 | AL | — |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | MD13209 | AL | — |

## Other

- **Enumeration date:** 06/13/2018
- **Last updated:** 06/13/2018