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Organization

AGAPE' WELLNESS CENTER & WOUND CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HUBERT H WATTY M.D (OWNER / MANAGER)
(918) 869-3466
Entity
Organization

Contact information

Practice address
PLOT 6 CLIFTON HILL, KINGSHILL, VI 00851
(340) 778-0688
Mailing address
P. O. BOX 9281 RTE # 2, KINGSHILL, VI 00851
(340) 778-0688

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23898
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200046880A
OK
05
200046880B
OK
01
700522158
MEDICARE B
OK
Enumeration date
02/01/2007
Last updated
09/20/2018
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