Provider Demographics
NPI:1275377426
Name:REDDY WELLNESS LLC
Entity type:Organization
Organization Name:REDDY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:777-744-7392
Mailing Address - Street 1:412 COUNTY ST # 3E
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5008
Mailing Address - Country:US
Mailing Address - Phone:774-473-9226
Mailing Address - Fax:866-786-5697
Practice Address - Street 1:412 COUNTY ST # 3E
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5008
Practice Address - Country:US
Practice Address - Phone:774-473-9226
Practice Address - Fax:866-786-5697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty