| Whitley Wellness Llc | |
|
8 Shipway Pl # C-8 Charlestown MA 02129-4301 | |
| (325) 439-9799 | |
| (617) 987-9739 |
| Full Name | Whitley Wellness Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8 Shipway Pl # C-8, Charlestown, Massachusetts |
| Authorized Official Name and Position | Geoffrey Whitley (OWNER) |
| Authorized Official Contact | 6176209757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whitley Wellness Llc 8 Shipway Pl # C-8 Charlestown MA 02129-4301 Ph: (325) 439-9799 | Whitley Wellness Llc 8 Shipway Pl # C-8 Charlestown MA 02129-4301 Ph: (325) 439-9799 |
| NPI Number | 1205298148 |
|---|---|
| Provider Enumeration Date | 03/21/2016 |
| Last Update Date | 03/19/2018 |
| Medicare PECOS PAC ID | 9537420963 |
|---|---|
| Medicare Enrollment ID | O20180228001331 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205298148 | NPI | - | NPPES |
| Provider Name | Geoffrey L Whitley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083994404 PECOS PAC ID: 4587836408 Enrollment ID: I20111018000574 |
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