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A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Gynecology |
207VG0400X | 16 | Physician/Obstetrics & Gynecology |
| NPI # | 1790335164 |
| LBN Legal business name | CUSTOMIZED WELLNESS, LLC |
| Authorized official | AMANDA LUCERO - (OWNER/PROVIDER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/17/2019 |
| Last updated | 09/17/2019 - About 7 years ago |
| Identifiers | n/a |
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CUSTOMIZED WELLNESS, LLC
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CUSTOMIZED WELLNESS, LLC