Organization
HOOSIER WELLNESS PROVIDERS, LLC
Active
Parent organization
HOOSIER WELLNESS PROVIDERS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOOSIER WELLNESS PROVIDERS, LLC
Authorized official
KIRILL VESSELOV (PRESIDENT)
(561) 635-2400
Entity
Organization
Contact information
Practice address
421 W 1ST ST, BLOOMINGTON, IN 47403-2403
(561) 635-2400
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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