Organization
KETAMINE HOLISTIC WELLNESS CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYMBERLY TESH PIERCE-DEW (BILLING MANAGER)
(941) 720-5448
Entity
Organization
Contact information
Practice address
1024 HIGHWAY A1A STE 152, SATELLITE BEACH, FL 32937-2341
(321) 777-8040
(321) 821-0212
Mailing address
1024 HIGHWAY A1A STE 152, SATELLITE BEACH, FL 32937-2341
(321) 777-8040
(321) 821-0212
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
—
—
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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