| Total Wellness Advocates | |
|
114 Ineichen St Rayville LA 71269-3223 | |
| (708) 710-9969 | |
| Not Available |
| Full Name | Total Wellness Advocates |
|---|---|
| Speciality | Clinic/Center |
| Location | 114 Ineichen St, Rayville, Louisiana |
| Authorized Official Name and Position | Shandra N Smith (OWNER) |
| Authorized Official Contact | 7087109969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Total Wellness Advocates 114 Ineichen St Rayville LA 71269-3223 Ph: (708) 710-9969 | Total Wellness Advocates 114 Ineichen St Rayville LA 71269-3223 Ph: (708) 710-9969 |
| NPI Number | 1942754064 |
|---|---|
| Provider Enumeration Date | 08/05/2016 |
| Last Update Date | 12/21/2023 |
| Certification Date | 12/21/2023 |
| Medicare PECOS PAC ID | 8527343151 |
|---|---|
| Medicare Enrollment ID | O20170323000113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942754064 | NPI | - | NPPES |
| Provider Name | Bryan Bolwahnn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043247331 PECOS PAC ID: 6406822527 Enrollment ID: I20040909000280 |
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