Natural Wellness Center of Ellijay

Primary specialty

SpecialistTaxonomy code 174400000X

License

MT001421 Issued in GA

Legal business name

NATURAL WELLNESS CENTER OF ELLIJAY

Practice address

29 North Ave Ste 1
Ellijay, GA 30540-3565

Phone

(706) 698-4002

Fax

(706) 698-4005

NPI assigned

Sep 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Houle, LMT

Title

Owner

Phone

(706) 698-4002

Specialties & licenses 4

Addresses

Other names 1

• Ellijay Massage Therapy Center Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1619126166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NORTH AVE STE 1",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403565",
            "telephone_number": "706-698-4002",
            "fax_number": "706-698-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 NORTH AVE STE 1",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403565",
            "telephone_number": "706-698-4002",
            "fax_number": "706-698-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATURAL WELLNESS CENTER OF ELLIJAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "HOULE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-698-4002",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007764",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "MT001421",
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellijay Massage Therapy Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Specialist in Ellijay, GA
• Providers in Ellijay, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.