NPI 1003099235

Advanced Wellness Group INC

Organisation Ph.D. Medical Genetics Quinlan, TX

Practice location

Address: 2705 E Quinlan Pkwy, Quinlan, TX 75474-8688
Phone: (903) 447-5470
Mailing address: PO Box 789, Quinlan, TX 75474-0014

Authorised official

Name: Kenneth Ronald Dority
Title: Supervising Physician
Phone: (903) 447-5470

Registered specialties

Ph.D. Medical Genetics Primary

Other Service Providers Taxonomy 170100000X Licence K0722 (TX)

Other Medical Genetics, Ph.D. Medical Genetics providers in Texas →

Registry record

NPI: 1003099235
Entity type: Organization
NPI issued: 11 Dec 2007
Record last updated: 17 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.