Organization
PRIMARY HOLISTIC CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY FLANNELLY FNP-C (NURSE PRACTITIONER)
(848) 404-6717
Entity
Organization
Contact information
Practice address
531 TINTON AVE, TINTON FALLS, NJ 07724-3211
(848) 404-6717
Mailing address
531 TINTON AVE, TINTON FALLS, NJ 07724-3211
(848) 404-6717
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548975840.
NEW JERSEY
NJ
Enumeration date
04/26/2023
Last updated
04/26/2023
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