OrganizationActive
Functional Wellness LLC
NPI 1457290710 · Clinic/Center · Keene, NH
Provider details
- NPI number
- 1457290710
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Gray, Member(603) 606-0487
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
310 Marlboro St Ste 267
Keene, NH 03431-4118
Phone: (518) 496-0219
Approximate (ZIP-level) locationGet directions
Mailing address
310 Marlboro St Ste 267
Keene, NH 03431-4118
Registry dates
- Enumerated
- 2026-03-25
- Last updated
- 2026-03-25
- Certified
- 2026-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.