Bonnell Health and Wellness
Organization
Active NPI
Clinic/Center · Carthage, TN
NPI 1629620950 · NPPES record last updated Jan 30, 2020
Key facts
- NPI
- 1629620950
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- BONNELL HEALTH AND WELLNESS
- Practice address
- 19 Bonnell Lane
Suite a
Carthage, TN 38030
- Phone
- (618) 588-0880
- Fax
- (615) 588-0881
- NPI assigned
- Jul 16, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- FUTURA MEDICAL CLINIC
Authorized official
- Name
- Darce Latsis
- Title
- Operations Manager
- Phone
- (615) 588-0880
Corporate family (same tax ID) 24
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National Provider Directory
- Tax ID family
- Onsite Care Inc (25 organizations share this tax ID)
- Part of
- Onsite Care Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Clinic/Center |
261Q00000X |
|
|
Yes |
Addresses
Primary practice location
19 Bonnell Lane
Suite a
Carthage, TN 38030
Mailing address
560 S 300 E Ste 275
Salt Lake City, UT 84111-3586
Phone (801) 441-1002
Other names
- Bonnell Health and Wellness Center Doing business as