| Vanquish Llc | |
|
1005 Rose Hill Cir Hueytown AL 35023-3660 | |
| (205) 386-0809 | |
| Not Available |
| Full Name | Vanquish Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1005 Rose Hill Cir, Hueytown, Alabama |
| Authorized Official Name and Position | Kristie Pettway (OWNER) |
| Authorized Official Contact | 2053860809 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanquish Llc 1005 Rose Hill Cir Hueytown AL 35023-3660 Ph: (205) 386-0809 | Vanquish Llc 1005 Rose Hill Cir Hueytown AL 35023-3660 Ph: (205) 386-0809 |
| NPI Number | 1740974302 |
|---|---|
| Provider Enumeration Date | 06/06/2023 |
| Last Update Date | 06/07/2023 |
| Certification Date | 06/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740974302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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