OrganizationActive
Advanced Wellness Group Inc
NPI 1003099235 · Ph.D. Medical Genetics · Quinlan, TX
Provider details
- NPI number
- 1003099235
- Entity type
- Organization
- Primary specialty
- Ph.D. Medical GeneticsOther Service Providers
- Authorized official
- Kenneth Dority, Supervising Physician
- License
- K0722 (TX)
Mailing address
Po Box 789
Quinlan, TX 75474-0014
Registry dates
- Enumerated
- 2007-12-11
- Last updated
- 2012-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.