Organization
MANIFEST WELLNESS SERVICES LLC
Active
Other names
MANIFEST WEIGHT LOSS: LOSE WEIGHT, LOVE LIFE, NO RESTRICTIONS.
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIEVE IFEANYICHUKWU (CHIEF EXECUTIVE OFFICER)
(443) 531-4264
Entity
Organization
Contact information
Practice address
6340 SECURITY BLVD STE B16, WOODLAWN, MD 21207-5173
(443) 531-4264
Mailing address
6008 PLUMER AVE, BALTIMORE, MD 21206-2759
(443) 531-4264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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