| Advanced Medical & Wellness Center, Inc. | |
|
3060 Dayton Xenia Rd Ste A Beavercreek OH 45434-6393 | |
| (937) 427-2225 | |
| (937) 405-1078 |
| Full Name | Advanced Medical & Wellness Center, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 3060 Dayton Xenia Rd Ste A, Beavercreek, Ohio |
| Authorized Official Name and Position | Julie A Black (PRESIDENT) |
| Authorized Official Contact | 9374272225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Medical & Wellness Center, Inc. 3060 Dayton Xenia Rd Ste C Beavercreek OH 45434-6393 Ph: (937) 427-2225 | Advanced Medical & Wellness Center, Inc. 3060 Dayton Xenia Rd Ste A Beavercreek OH 45434-6393 Ph: (937) 427-2225 |
| NPI Number | 1598281057 |
|---|---|
| Provider Enumeration Date | 08/16/2017 |
| Last Update Date | 10/17/2022 |
| Medicare PECOS PAC ID | 0547536187 |
|---|---|
| Medicare Enrollment ID | O20171025002788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598281057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Derek R Black |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881781490 PECOS PAC ID: 2163406216 Enrollment ID: I20120404000722 |
| Provider Name | Justin Scott Vinson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1336541556 PECOS PAC ID: 9830412147 Enrollment ID: I20141217001716 |
| Provider Name | Laura E Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932507290 PECOS PAC ID: 7911224506 Enrollment ID: I20150318002729 |
| Provider Name | Kelly C Beasley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073821997 PECOS PAC ID: 0840453262 Enrollment ID: I20191016001120 |
| Provider Name | Allison Harper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427510262 PECOS PAC ID: 1153710769 Enrollment ID: I20211118002983 |
| Provider Name | Dylan Robert Black |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1053180240 PECOS PAC ID: 7012368160 Enrollment ID: I20240112002392 |
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