Organization
HEALTHY LIFE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAVAN VENKATA DONTINENI (OWNER)
(740) 877-0478
Entity
Organization
Contact information
Practice address
1612 LANCASTER AVE STE B, REYNOLDSBURG, OH 43068-2639
(614) 599-3800
Mailing address
1612 LANCASTER AVE STE B, REYNOLDSBURG, OH 43068-2639
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
04/24/2023
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