| Xenon Wellness, Llc | |
|
810 Marvin Ln Green Bay WI 54311-5944 | |
| (920) 857-8112 | |
| Not Available |
| Full Name | Xenon Wellness, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 810 Marvin Ln, Green Bay, Wisconsin |
| Authorized Official Name and Position | Tabitha Bea Wallenfang (OWNER) |
| Authorized Official Contact | 9208578112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Xenon Wellness, Llc 810 Marvin Ln Green Bay WI 54311-5944 Ph: (920) 857-8112 | Xenon Wellness, Llc 810 Marvin Ln Green Bay WI 54311-5944 Ph: (920) 857-8112 |
| NPI Number | 1285208918 |
|---|---|
| Provider Enumeration Date | 05/17/2021 |
| Last Update Date | 05/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285208918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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