Organization
PHYSICIAN'S HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER GORMAN (PRESIDENT)
(772) 233-5155
Entity
Organization
Contact information
Practice address
2274 N US HIGHWAY 1, FORT PIERCE, FL 34946-8914
(772) 233-5155
Mailing address
2274 N US HIGHWAY 1, FORT PIERCE, FL 34946-8914
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/07/2016
Last updated
11/16/2016
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