# KETAMINE WELLNESS INSTITUTE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ketamine Wellness Institute, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740066216
- **Authorized official:** DR. BILAL LATEEF MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (919) 943-9122

## Contact information

- **Practice address:** 5915 FARRINGTON RD STE 105, CHAPEL HILL, NC 27517-9900
- **Practice address phone:** (907) 885-0206
- **Practice address fax:** (907) 600-5089
- **Mailing address:** 1335 CAPPOQUIN WAY, BURLINGTON, NC 27215-9396
- **Mailing address phone:** (907) 885-0206
- **Mailing address fax:** (907) 600-5089

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/31/2023
- **Last updated:** 03/22/2024