| Frontline Wellness Center Pllc | |
|
151 Wendover Dr Ste B Kingsport TN 37663-2655 | |
| (423) 712-1176 | |
| Not Available |
| Full Name | Frontline Wellness Center Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 151 Wendover Dr Ste B, Kingsport, Tennessee |
| Authorized Official Name and Position | Robin Hebert (OWNER) |
| Authorized Official Contact | 4237121176 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Frontline Wellness Center Pllc 4128 Fort Henry Dr Ste D125 Kingsport TN 37663-2260 Ph: (423) 712-1176 | Frontline Wellness Center Pllc 151 Wendover Dr Ste B Kingsport TN 37663-2655 Ph: (423) 712-1176 |
| NPI Number | 1881415040 |
|---|---|
| Provider Enumeration Date | 10/21/2024 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Medicare PECOS PAC ID | 2062940570 |
|---|---|
| Medicare Enrollment ID | O20250113000540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881415040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Robin Hebert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538638499 PECOS PAC ID: 3971031485 Enrollment ID: I20250307000276 |
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