Organization
ADDICTIVE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MINICHIELLO JR. RN, HHP (RN/HOLISTIC HEALTH PRACTITIONER)
(580) 216-9554
Entity
Organization
Contact information
Practice address
1630 SANTA FE ST, WAYNOKA, OK 73860-3946
(580) 216-9554
Mailing address
9929 COUNTY ROAD 350, WAYNOKA, OK 73860-6934
(580) 216-9554
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
—
—
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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