Organization
COSMIC BODY WELLNESS FELLOWSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAM TRUC NGUYEN DC, PHD, CCHT, LRT (FOUNDER & PRESIDENT)
(479) 226-2002
Entity
Organization
Contact information
Practice address
7 WOODLAND PL, FORT SMITH, AR 72904-2564
(479) 226-2002
Mailing address
PO BOX 3135, BENTONVILLE, AR 72712-7711
(479) 226-2002
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
282J00000X
Religious Nonmedical Health Care Institution
Primary
—
—
Other
Enumeration date
07/21/2025
Last updated
07/27/2025
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