Organization
INDIANA WELLNESS RX 2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL VESSELOV (OWNER)
(561) 556-3721
Entity
Organization
Contact information
Practice address
215 W 4TH ST STE 1, MISHAWAKA, IN 46544-1917
(561) 556-3721
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
05/05/2021
Last updated
06/07/2021
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