Organization
HOLISTIC WILL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELI KORNMILLER (SENIOR CREDENTIALING SPECIALIST)
(561) 672-8345
Entity
Organization
Contact information
Practice address
2500 QUANTUM LAKES DR STE 212, BOYNTON BEACH, FL 33426-8308
(561) 223-6200
(561) 223-6250
Mailing address
2500 QUANTUM LAKES DR STE 212, BOYNTON BEACH, FL 33426-8308
(561) 223-6200
(561) 223-6250
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
FL
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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