# BARDWELL WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1851970602
- **Authorized official:** CHRIS AUGUSTUS (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (270) 628-5445

## Contact information

- **Practice address:** 178 US HIGHWAY 51 N STE B, BARDWELL, KY 42023-9096
- **Practice address phone:** (270) 628-5445
- **Practice address fax:** (270) 628-3179
- **Mailing address:** 178 US HIGHWAY 51 N STE B, BARDWELL, KY 42023-9096
- **Mailing address phone:** (270) 628-5445
- **Mailing address fax:** (270) 628-3179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/07/2021
- **Last updated:** 04/07/2021