| Divinity Diagnostic & Wellness Inc | |
|
2002 20th St Ste B202 Kenner LA 70062-4403 | |
| (504) 667-3641 | |
| Not Available |
| Full Name | Divinity Diagnostic & Wellness Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 2002 20th St Ste B202, Kenner, Louisiana |
| Authorized Official Name and Position | Lateda T Williams (OWNER) |
| Authorized Official Contact | 5042746023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divinity Diagnostic & Wellness Inc 2002 20th St Ste B202 Kenner LA 70062-4403 Ph: (504) 667-3641 | Divinity Diagnostic & Wellness Inc 2002 20th St Ste B202 Kenner LA 70062-4403 Ph: (504) 667-3641 |
| NPI Number | 1336992437 |
|---|---|
| Provider Enumeration Date | 04/09/2024 |
| Last Update Date | 04/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336992437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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