Organization
WELLNITE MEDICAL GROUP PA
Active
Organization
WELLNITE MEDICAL GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA SWAN (CEO)
(855) 731-1410
Entity
Organization
Contact information
Practice address
1105 2ND ST S, NAMPA, ID 83651-3911
(650) 761-9770
Mailing address
2261 MARKET ST # 4058, SAN FRANCISCO, CA 94114-1612
(855) 731-1410
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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