Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Pain Medicine |
2081P2900X | 25 | Physician/Physical Medicine and Rehabilitation |
| NPI Number | 1891055026 |
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| LBN Legal business name | INCLUSIVE WELLNESS & REHABILITATION PLLC | ||||||||
| Authorized official | RONALD GREEN - (MEMBER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 05/22/2012 | ||||||||
| Last updated | 05/22/2012 - About 14 years ago | ||||||||
| Identifiers |
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