Organization
LIFESPAN WELLNESS LLC
Active
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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