Organization
NORTHSTAR WELLNESS LLC
Active
Organization
NORTHSTAR WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND WALLER SMITH LMT (MEMBER)
(816) 682-5819
Entity
Organization
Contact information
Practice address
810 E MAIN ST, RICHMOND, MO 64085-1908
(816) 682-5819
(855) 682-5819
Mailing address
810 E MAIN ST, RICHMOND, MO 64085-1908
(816) 682-5819
(855) 682-5819
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
2011011136
MO
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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