Lifelong Wellness Clinic Pllc is a health care provider in Eastland, TX. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location||711 W Main St, Eastland, TX 76448-2534, US|
|Practice Location Phone||254-629-1100|
|Practice Location Fax||254-629-1104|
|Legal Business Name||LIFELONG WELLNESS CLINIC PLLC|
|Enumeration Date ?||Jul 28, 2011|
|Last Update Date ?||Oct 23, 2013|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
|Specialty||Provider Type||Specialization||License||License State|
|Family Medicine||Allopathic & Osteopathic Physicians||N2319||Texas|
|Pediatrics||Allopathic & Osteopathic Physicians||P0309||Texas|
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Lifelong Wellness Clinic Pllc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official||Christopher Tidroski (D.O.)|
|Authorized Official Title/Position||OWNER|
|Authorized Official Phone Number||254-629-1100|