| Emerald Grove Wellness Llc | |
|
214 Brickyard Rd Mars PA 16046-3006 | |
| (724) 766-3825 | |
| (334) 344-7725 |
| Full Name | Emerald Grove Wellness Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 214 Brickyard Rd, Mars, Pennsylvania |
| Authorized Official Name and Position | Ryan Ganter (OWNER) |
| Authorized Official Contact | 7247663825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Grove Wellness Llc 214 Brickyard Rd Mars PA 16046-3006 Ph: (724) 766-3825 | Emerald Grove Wellness Llc 214 Brickyard Rd Mars PA 16046-3006 Ph: (724) 766-3825 |
| NPI Number | 1104427806 |
|---|---|
| Provider Enumeration Date | 11/08/2020 |
| Last Update Date | 11/08/2020 |
| Certification Date | 11/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104427806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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