Organization
HEALTHY BODY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLIE MCDANIEL MOWERY NP-C (OWNER)
(925) 518-6122
Entity
Organization
Contact information
Practice address
2515 LADUE LN, FORT WAYNE, IN 46804-2796
(925) 518-6122
Mailing address
7619 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 407-8006
(260) 407-8006
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
71006194A
IN
Other
Enumeration date
07/18/2017
Last updated
07/18/2017
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