| Grow The Vine Speech & Wellness Gym | |
|
527 Poppell Dr Lakeland FL 33813-1139 | |
| (863) 712-6030 | |
| Not Available |
| Full Name | Grow The Vine Speech & Wellness Gym |
|---|---|
| Speciality | Clinic/center |
| Location | 527 Poppell Dr, Lakeland, Florida |
| Authorized Official Name and Position | Julie L Barrientes (OWNER/CHIEF SLP) |
| Authorized Official Contact | 8637126030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grow The Vine Speech & Wellness Gym 4664 E County Road 540a Lakeland FL 33813-4472 Ph: (863) 940-9863 | Grow The Vine Speech & Wellness Gym 527 Poppell Dr Lakeland FL 33813-1139 Ph: (863) 712-6030 |
| NPI Number | 1104379304 |
|---|---|
| Provider Enumeration Date | 07/25/2016 |
| Last Update Date | 02/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104379304 | NPI | - | NPPES |
| 887352600 | Medicaid | FL | |
| 102011900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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