Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1073181269 |
| LBN Legal business name | AGAPE TRINITY WELLNESS & HEALTH |
| Authorized official | VICTOR STEWART - (PRINCIPAL) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 06/14/2021 |
| Last updated | 06/14/2021 - About 5 years ago |
| Identifiers | n/a |
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