Organization
ECLIPSE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LUCKANISH (OWNER)
(484) 919-1607
Entity
Organization
Contact information
Practice address
623 W NEWPORT PIKE, WILMINGTON, DE 19804-3235
(302) 777-5473
(302) 777-5483
Mailing address
623 W NEWPORT PIKE, WILMINGTON, DE 19804-3235
(302) 777-5473
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250694990
—
DE
Enumeration date
10/07/2021
Last updated
12/15/2023
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