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Organization

LIFESPAN WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RENATA HOLLIMAN FNP-C (MANAGER)
(251) 422-1979
Entity
Organization

Contact information

Practice address
101 ROUSELLE PL STE A, OCEAN SPRINGS, MS 39564-3074
(228) 327-8210
Mailing address
101 ROUSELLE PL STE A, OCEAN SPRINGS, MS 39564-3074
(228) 327-8210

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1127426
MS

Other

Enumeration date
07/27/2018
Last updated
07/27/2018
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