| Family Wellness Clinic | |
|
400 N 4th St Saint Louis MO 63102-2601 | |
| (862) 216-2617 | |
| Not Available |
| Full Name | Family Wellness Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 400 N 4th St, Saint Louis, Missouri |
| Authorized Official Name and Position | Kayode Balogun (CEO) |
| Authorized Official Contact | 8622162617 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Wellness Clinic 400 N 4th St Apt 1804 Saint Louis MO 63102-2642 Ph: (862) 216-2617 | Family Wellness Clinic 400 N 4th St Saint Louis MO 63102-2601 Ph: (862) 216-2617 |
| NPI Number | 1134888621 |
|---|---|
| Provider Enumeration Date | 12/11/2021 |
| Last Update Date | 12/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134888621 | NPI | - | NPPES |
| 210079717 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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