Provider Demographics
NPI:1306103502
Name:FEEL WELL HEALTH CENTER OF SOUTHINGTON, PC
Entity type:Organization
Organization Name:FEEL WELL HEALTH CENTER OF SOUTHINGTON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-378-2892
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:888-431-8819
Practice Address - Street 1:710 MAIN ST
Practice Address - Street 2:BLDG 4
Practice Address - City:PLANTSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06479-1565
Practice Address - Country:US
Practice Address - Phone:860-378-2892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FEEL WELL HEALTH CENTER OF SOUTHINGTON, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-12
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site