Organization
HEALTHSTAT WELLNESS PCSB-LAKELAND DISPENSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
(704) 936-5546
Entity
Organization
Contact information
Practice address
3215 WINTER LAKE RD, LAKELAND, FL 33803-9709
(704) 529-6161
Mailing address
4651 CHARLOTTE PARK DR STE 300, CHARLOTTE, NC 28217-1916
(704) 936-5546
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
—
—
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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