| Prodigy Wellness Collective | |
|
200 E Broad St Texarkana AR 71854-5904 | |
| (210) 860-3493 | |
| Not Available |
| Full Name | Prodigy Wellness Collective |
|---|---|
| Speciality | Clinic/center |
| Location | 200 E Broad St, Texarkana, Arkansas |
| Authorized Official Name and Position | Jessica Renee Mccarty (OWNER, YOGA THERAPIST) |
| Authorized Official Contact | 2108603493 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodigy Wellness Collective 7 Carol Ln Texarkana TX 75501-9700 Ph: (210) 860-3493 | Prodigy Wellness Collective 200 E Broad St Texarkana AR 71854-5904 Ph: (210) 860-3493 |
| NPI Number | 1861173874 |
|---|---|
| Provider Enumeration Date | 07/31/2023 |
| Last Update Date | 07/31/2023 |
| Certification Date | 07/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861173874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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