Basic Information
| Provider Information | |||||||||
| NPI: | 1780867341 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTH ENHANCEMENTS, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 213 | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 651020213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736382478 | ||||||||
| FaxNumber: | 5736365315 | ||||||||
| Practice Location | |||||||||
| Address1: | 1739 ELM COURT PLAZA | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | JEFFERSON CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736382478 | ||||||||
| FaxNumber: | 5736365315 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2007 | ||||||||
| LastUpdateDate: | 12/06/2007 | ||||||||
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| AuthorizedOfficialLastName: | LUECKENHOFF | ||||||||
| AuthorizedOfficialFirstName: | REBECCA | ||||||||
| AuthorizedOfficialMiddleName: | R. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5736382478 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R3D22 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.