Organization
ORIGINS WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AME COCHENOUR (FINANCIAL DIRECTOR)
(817) 697-4345
Entity
Organization
Contact information
Practice address
10345 ALTA VISTA RD, FORT WORTH, TX 76244-6501
(817) 562-2828
(817) 768-6940
Mailing address
10345 ALTA VISTA RD, FORT WORTH, TX 76244-6501
(817) 562-2828
(817) 768-6940
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/07/2023
Last updated
06/17/2024
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