Provider Demographics
NPI:1366225708
Name:SYNERGY HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:SYNERGY HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:EBUNOLUWA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-608-0421
Mailing Address - Street 1:10426 HALFHITCH DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2570
Mailing Address - Country:US
Mailing Address - Phone:832-608-0421
Mailing Address - Fax:
Practice Address - Street 1:750 W DIMOND BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1500
Practice Address - Country:US
Practice Address - Phone:832-608-0421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service