Organization
WELLINGTON PROVIDER GROUP, PC
Active
Parent organization
WELLINGTON PROVIDER GROUP, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLINGTON PROVIDER GROUP, PC
Authorized official
BRITTANY DENNIS (CREDENTIALING MANAGER)
(859) 518-8817
Entity
Organization
Contact information
Practice address
400 RENAISSANCE CTR STE 2200, DETROIT, MI 48243-1502
(859) 439-0400
Mailing address
535 WELLINGTON WAY STE 330, LEXINGTON, KY 40503-1331
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/25/2022
Last updated
11/25/2022
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