Organization
GATEWAY WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ANTHONY WHITE MD (PRESIDENT/OWNER)
(614) 453-1065
Entity
Organization
Contact information
Practice address
112 JEFFERSON AVE, SUITE 201, COLUMBUS, OH 43215-1861
(614) 453-1065
(614) 453-1078
Mailing address
112 JEFFERSON AVE, SUITE 201, COLUMBUS, OH 43215-1861
(614) 453-1065
(614) 453-1078
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35072866
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2138485
—
OH
Enumeration date
07/15/2009
Last updated
07/15/2009
Update your record
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