| Proactive Nutrition & Wellness Inc | |
|
1455 Laurel Ave Coos Bay OR 97420-2167 | |
| (727) 409-0016 | |
| Not Available |
| Full Name | Proactive Nutrition & Wellness Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 1455 Laurel Ave, Coos Bay, Oregon |
| Authorized Official Name and Position | Andrew Winquist (PRESIDENT) |
| Authorized Official Contact | 7274090016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Nutrition & Wellness Inc 1455 Laurel Ave Coos Bay OR 97420-2167 Ph: (727) 409-0016 | Proactive Nutrition & Wellness Inc 1455 Laurel Ave Coos Bay OR 97420-2167 Ph: (727) 409-0016 |
| NPI Number | 1467075663 |
|---|---|
| Provider Enumeration Date | 05/21/2020 |
| Last Update Date | 05/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467075663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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