ORIGINS BIRTH SERVICES, LLC
Midwife at Alta Vista Rd, Keller, TX

License number
Texas 99220
Category
Midwife
Type
Midwife, Lay
Owner
Name: MRS. KAITLYN ELIZABETH WAGES CPM, LM
Title: MIDWIFE/OWNER
Phone: (817) 966-8075
Address
Address
10340 Alta Vista Rd SUITE 1A, Keller, TX 76244
National Provider ID: 1003211756
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ORIGINS BIRTH SERVICES, LLC

Keller, TX  -  Fort Worth, TX

Registration:
Oct 22, 2013
Phone:
(817) 562-2828 (Phone)
Addresses:
10340 Alta Vis Rd, Keller, TX 76244 (Mailing)
4148 Capstone Dr, Keller, TX 76244
10340 Alta Vis Rd, Fort Worth, TX 76244
State ID:
0801870454
Business type:
Domestic Limited Liability Company (LLC)
Managing M, Managing Members:
Gina Phillips (Director), 13037 Fencerow Rd, Keller, TX 76244,Kaitlyn Wages (Managing M, Managing Member), 8301 John's Way, North Richland Hills, TX 76182
TIN:
32052286484
Categories:
Birthing Centers

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