Organization
ENHANCED WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHERINE FELICE BLANCO RHIA (CLINIC ADMIN)
(601) 364-1132
Entity
Organization
Contact information
Practice address
1855 LAKELAND DRIVE, STE M20, JACKSON, MS 39216
(601) 364-1132
(601) 364-1134
Mailing address
1855 LAKELAND DRIVE, STE M20, JACKSON, MS 39216
(601) 364-1132
(601) 364-1134
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
09/25/2006
Last updated
10/07/2013
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