Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Student Health |
261QS1000X | |||
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice |
| NPI # | 1205641388 |
| LBN Legal business name | COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY |
| Authorized official | TARA BAIR - (PRESIDENT/CEO) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 02/07/2025 |
| Last updated | 03/20/2025 - More than a year ago |
| Identifiers | n/a |
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