Lifelong Wellness Center INC

NPI #1043413487 in Tahlequah, Oklahoma

Provider Information

NPI Number: 1043413487
Entity Type: Organization
Organization Name: Lifelong Wellness Center INC
Primary Specialty: Family Medicine
Enumeration Date: Jun 5, 2007
Last Updated: Oct 18, 2007

Practice Location

Address: 1203 E ROSS BYP STE C
City: Tahlequah
State: Oklahoma
ZIP Code: 74464-4188
Phone: (918) 458-0700

Authorized Official

Name: EDITH-ELAINE HAMILL HODSON
Title: PRESIDENT
Phone: (918) 453-8550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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