Organization
GREEN WAVE FAMILY WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C CLUXTON PH.D. (MANAGING OFFICER)
(850) 215-5657
Entity
Organization
Contact information
Practice address
215 FOREST PARK CIR, PANAMA CITY, FL 32405-4916
(850) 215-5657
(850) 215-5658
Mailing address
215 FOREST PARK CIR, PANAMA CITY, FL 32405-4916
(850) 215-5657
(850) 215-5658
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH-6603
FL
106H00000X
Marriage & Family Therapist
MT-0001678
FL
111N00000X
Chiropractor
Primary
CH 8571
FL
Other
Enumeration date
07/24/2007
Last updated
07/24/2007
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