Organization
WELLNESSCONNECT HEALTHCARE AND PREVENTIVE MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE COPELAND CPC (BILLING MANAGER/CREDENTIALING)
(256) 907-2493
Entity
Organization
Contact information
Practice address
2011 GALLATIN ST SW, HUNTSVILLE, AL 35801-4510
(256) 907-2493
(256) 281-8134
Mailing address
2011 GALLATIN ST SW, HUNTSVILLE, AL 35801-4510
(256) 907-2493
(256) 907-1726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00013209
AL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
MD13209
AL
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
MD13209
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285741553
NPI
AL
01
—
1760437313
NPI
AL
01
—
1912186032
NPI
AL
Enumeration date
06/13/2018
Last updated
06/13/2018
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