Organization
HEALTH WELLNESS PROMOTION LLC
Active
Other names
Bolton Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY MONETT-SHAMON THOMAS DNP (FNP-C/OWNER)
(601) 866-7723
Entity
Organization
Contact information
Practice address
115 W MADISON ST, BOLTON, MS 39041-3209
(601) 866-7723
(601) 866-7773
Mailing address
PO BOX 360, BOLTON, MS 39041-0360
(601) 866-7723
(601) 866-7773
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
R869143
MS
261QR1300X
Rural Health Clinic/Center
Primary
R869143
MS
Other
Enumeration date
07/02/2015
Last updated
12/08/2020
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