Provider Demographics
NPI:1194407619
Name:COMPLETELY WELL HEALTH & WELLNESS PC
Entity type:Organization
Organization Name:COMPLETELY WELL HEALTH & WELLNESS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:KUZDAK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-770-8280
Mailing Address - Street 1:25500 MEADOWBROOK RD STE 260
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1883
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25500 MEADOWBROOK RD STE 260
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1883
Practice Address - Country:US
Practice Address - Phone:248-639-4131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty