| Manifest Wellness, Llc | |
|
2701 International Ln Ste 105 Madison WI 53704-3126 | |
| (608) 291-3676 | |
| (608) 716-3156 |
| Full Name | Manifest Wellness, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2701 International Ln Ste 105, Madison, Wisconsin |
| Authorized Official Name and Position | Jennifer Klekamp (OWNER, PROGRAM DIRECTOR) |
| Authorized Official Contact | 6089827698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manifest Wellness, Llc Po Box 930155 Verona WI 53593-0155 Ph: (608) 291-3676 | Manifest Wellness, Llc 2701 International Ln Ste 105 Madison WI 53704-3126 Ph: (608) 291-3676 |
| NPI Number | 1750064283 |
|---|---|
| Provider Enumeration Date | 08/10/2023 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750064283 | NPI | - | NPPES |
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