Longevity Wellness Group

NPI #1538314562 in Austin, Texas

Provider Information

NPI Number
1538314562
Entity Type
Organization
Organization Name
Longevity Wellness Group
Primary Specialty
Internal Medicine
Enumeration Date
Nov 18, 2008
Last Updated
Apr 15, 2013

Practice Location

Address
4101 MARATHON BOULEVARD
City
Austin
State
Texas
ZIP Code
78756-4026
Phone
(512) 323-9222

Authorized Official

Name
DR. GREGORY TRENT DAVIS, M.D.
Title
CEO
Phone
(512) 323-9222

Specialties & Taxonomy Codes

Specialty
Chiropractor - InternistInternist
Internal Medicine

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