Organization
WHOLISTIC MEDICINE CLINIC OF STUART, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM G TYE III (MANAGING PARTNER)
(772) 287-2677
Entity
Organization
Contact information
Practice address
55 SE OSCEOLA ST, SUITE 102, STUART, FL 34994-2149
(772) 288-3668
Mailing address
55 SE OSCEOLA ST, SUITE 102, STUART, FL 34994-2149
(772) 288-3668
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24574
BLUECROSS BLUESHIELD
FL
Enumeration date
12/28/2006
Last updated
08/22/2020
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