Organization
WHOLISTICALLY DIVINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA GORDON CD (OWNER)
(614) 381-1359
Entity
Organization
Contact information
Practice address
185 HEFFRON CIR, MAINEVILLE, OH 45039-7342
(614) 381-1359
Mailing address
185 HEFFRON CIR, MAINEVILLE, OH 45039-7342
(614) 381-1359
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
261QB0400X
Birthing Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
09/11/2024
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