Organization
FUSION OF WELLNESS: BODY, MIND, AND SOUL, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FABIENNE NADEEN WITHERSPOON NP-C (OWNER/NURSE PRACTITIONER)
(217) 274-6966
Entity
Organization
Contact information
Practice address
712 N MAIN ST, GEORGETOWN, IL 61846-1440
(217) 274-6966
Mailing address
712 N MAIN ST, GEORGETOWN, IL 61846-1440
(217) 274-6966
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
209009867
IL
Other
Enumeration date
03/27/2018
Last updated
05/07/2018
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