Provider Demographics
NPI:1447496435
Name:HARNISCH WELLNESS CLINIC INC
Entity type:Organization
Organization Name:HARNISCH WELLNESS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:HELNUT
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARNISCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-584-2624
Mailing Address - Street 1:1165 GREEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-4205
Mailing Address - Country:US
Mailing Address - Phone:615-584-2624
Mailing Address - Fax:931-359-6894
Practice Address - Street 1:1869 HIGHWAY 45 BYP
Practice Address - Street 2:SUITE 2B
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2464
Practice Address - Country:US
Practice Address - Phone:731-512-1880
Practice Address - Fax:731-512-1887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000015067261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care