Organization
KETAMINE WELLNESS CENTERS JACKSONVILLE
Active
Parent organization
KETAMINE WELLNESS CENTERS ARIZONA LLC
Other names
Ketamine Wellness Centers
Organization subpart
Yes
Provider details
NPI number
Legal business name
KETAMINE WELLNESS CENTERS ARIZONA LLC
Authorized official
MS. ANITA JERGER (EXECUTIVE ASSISTANT)
(855) 538-9355
Entity
Organization
Contact information
Practice address
3753-2 CARDINAL POINT DR, JACKSONVILLE, FL 32257-5582
(855) 538-9355
(844) 538-9355
Mailing address
113 W HOOVER AVE STE 101, MESA, AZ 85210-5214
(855) 538-9355
(844) 538-9355
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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