360 Body Wellness INC
NPI #1679024228 in Glen Carbon, Illinois
Provider Information
- NPI Number
- 1679024228
- Entity Type
- Organization
- Organization Name
- 360 Body Wellness INC
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Oct 19, 2016
- Last Updated
- Oct 19, 2016
Practice Location
- Address
- 3407 IL STATE ROUTE 157
- City
- Glen Carbon
- State
- Illinois
- ZIP Code
- 62034
- Phone
- (618) 288-3610
Authorized Official
- Name
- MR. PHILIP S DUDAK, FNP-C
- Title
- FAMILY NURSE PRACTITIONER
- Phone
- (314) 753-2233
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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