Xenon Wellness, Llc | |
810 Marvin Ln Green Bay WI 54311-5944 | |
(920) 857-8112 | |
Not Available |
Full Name | Xenon Wellness, Llc |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 810 Marvin Ln, Green Bay, Wisconsin |
Authorized Official Name and Position | Tabitha Bea Wallenfang (OWNER) |
Authorized Official Contact | 9208578112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Xenon Wellness, Llc 810 Marvin Ln Green Bay WI 54311-5944 Ph: (920) 857-8112 | Xenon Wellness, Llc 810 Marvin Ln Green Bay WI 54311-5944 Ph: (920) 857-8112 |
NPI Number | 1285208918 |
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Provider Enumeration Date | 05/17/2021 |
Last Update Date | 05/17/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285208918 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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