Organization
CREATIVE WELLNESS LLC
Active
Other names
Better Balance
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA DIANNE CORN (PRESIDENT)
(561) 427-7200
Entity
Organization
Contact information
Practice address
18947 125TH AVE N, JUPITER, FL 33478-3792
(561) 427-7200
(561) 427-7203
Mailing address
18947 125TH AVE N, JUPITER, FL 33478-3792
(561) 427-7200
(561) 427-7203
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD4181
RAILROAD MEDICARE
FL
01
—
Y915K
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
05/19/2006
Last updated
08/18/2008
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