| Mentorup Life Lab & Clinic | |
|
535 Jack Warner Pkwy Ne Ste G2 Tuscaloosa AL 35404-5715 | |
| (205) 771-2261 | |
| Not Available |
| Full Name | Mentorup Life Lab & Clinic |
|---|---|
| Speciality | General Practice |
| Location | 535 Jack Warner Pkwy Ne Ste G2, Tuscaloosa, Alabama |
| Authorized Official Name and Position | Ellory Kate Johnson (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2057712261 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mentorup Life Lab & Clinic 4202 20th St Ne Tuscaloosa AL 35404-1502 Ph: (205) 771-2261 | Mentorup Life Lab & Clinic 535 Jack Warner Pkwy Ne Ste G2 Tuscaloosa AL 35404-5715 Ph: (205) 771-2261 |
| NPI Number | 1063104511 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063104511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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