Organization
GLOVES UP BOXING GYM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIA WINFIELD QMHS (OWNER)
(614) 900-4621
Entity
Organization
Contact information
Practice address
4300 E BROAD ST, COLUMBUS, OH 43213-1243
(614) 900-4621
Mailing address
5254 LINGLE LN, COLUMBUS, OH 43213-7627
(614) 900-4621
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033837737
—
OH
05
—
1255059960
—
OH
Enumeration date
12/19/2022
Last updated
12/19/2022
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