| Sedalia Wellness Center, Llc | |
|
1721 S Ingram Ave Sedalia MO 65301-7535 | |
| (660) 827-9875 | |
| (660) 827-9879 |
| Full Name | Sedalia Wellness Center, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1721 S Ingram Ave, Sedalia, Missouri |
| Authorized Official Name and Position | Tara Michelle Brown (OWNER) |
| Authorized Official Contact | 5732684419 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sedalia Wellness Center, Llc 1721 S Ingram Ave Sedalia MO 65301-7535 Ph: (573) 268-4419 | Sedalia Wellness Center, Llc 1721 S Ingram Ave Sedalia MO 65301-7535 Ph: (660) 827-9875 |
| NPI Number | 1063836484 |
|---|---|
| Provider Enumeration Date | 02/05/2014 |
| Last Update Date | 02/05/2014 |
| Medicare PECOS PAC ID | 8022240704 |
|---|---|
| Medicare Enrollment ID | O20140411000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063836484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2004033738 (Missouri) | Primary |
| Provider Name | Tara Michelle Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427090380 PECOS PAC ID: 9931331618 Enrollment ID: I20140411000531 |
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