OrganizationEnhanced Wellness Of Oak Grove, PllcNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address56 98 Place Blvd, Hattiesburg, MS 39402-8603(601) 264-7286PECOS EnrollmentBased on the most recent information from CMS, provider Enhanced Wellness Of Oak Grove, Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1154564920Provider TypeOrganizationFull NameEnhanced Wellness Of Oak Grove, PllcSubpartNoEnumeration Date4/9/2009Last Updated11/15/2021Contact InformationPractice LocationPractice Address56 98 Place Blvd, Hattiesburg, MS 39402-8603Phone(601) 264-7286Fax(601) 450-4640Mailing LocationMailing Address56 98 Place Blvd, Hattiesburg, MS 39402-8603Phone(601) 264-7286Fax(601) 450-4640Authorized OfficialNameRyba, Betty Laura (Provider/Owner)Phone(601) 264-7286Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer