Organization
EXQUISITE WELLNESS BAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRINCESS LOMAX (CEO)
(312) 671-3800
Entity
Organization
Contact information
Practice address
47 W POLK ST # 100-203, CHICAGO, IL 60605-2000
(312) 852-3655
Mailing address
5456 PEACHTREE BLVD # 121, ATLANTA, GA 30341-2235
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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