Innovative Wellness Group LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

INNOVATIVE WELLNESS GROUP LLC

Practice address

1640 Cornwall Rd
Lebanon, PA 17042-7405

Phone

(717) 272-2816

NPI assigned

Jan 21, 2019

Organization subpart

No

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

Authorized official

Name

Philip Yoder

Title

Owner

Phone

(717) 272-2816

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548028800000",
    "number": "1770057929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 CORNWALL RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427405",
            "telephone_number": "717-272-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 CORNWALL RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427405",
            "telephone_number": "717-272-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-272-2816"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Health Service Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.