| Park City Wellness Center, Llc | |
|
1000 Lafayette Blvd Suite 1142 Bridgeport CT 06604-4725 | |
| (203) 395-8412 | |
| (203) 683-5901 |
| Full Name | Park City Wellness Center, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1000 Lafayette Blvd, Bridgeport, Connecticut |
| Authorized Official Name and Position | Hope Taylor (OWNER) |
| Authorized Official Contact | 2033958412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park City Wellness Center, Llc 1000 Lafayette Blvd Suite 1142 Bridgeport CT 06604-4725 Ph: (203) 395-8412 | Park City Wellness Center, Llc 1000 Lafayette Blvd Suite 1142 Bridgeport CT 06604-4725 Ph: (203) 395-8412 |
| NPI Number | 1700330446 |
|---|---|
| Provider Enumeration Date | 08/11/2016 |
| Last Update Date | 09/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700330446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 002646 (Connecticut) | Primary |
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