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NPI Code Detail

MEDICARE: PROFESSIONAL WELLNESS CENTERS, LLC

MEDICARE: PROFESSIONAL WELLNESS CENTERS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor9783TX

General Provider Information

NPI Number : 1609181296
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROFESSIONAL WELLNESS CENTERS, LLC
Provider Business Mailing Address
First Line : 1416 CAMPBELL RD
Second Line : 100
City : HOUSTON
State : TX
Zip : 77055-4752
Country : US
Telephone Number : 832-358-2225
Fax Number :
Provider Business Practice Location Address
First Line : 1416 CAMPBELL RD
Second Line : 100
City : HOUSTON
State : TX
Zip : 77055-4752
Country : US
Telephone Number : 832-358-2225
Fax Number : 832-358-2226
Authorized Official
Title or Position : OWNER
Name : DR. SUHYUN AN
Credential : D.C.
Telephone Number : 832-358-2225
Provider Enumeration Date : 08/09/2010
Last Update Date : 08/09/2010

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Directions to “PROFESSIONAL WELLNESS CENTERS, LLC ” Practice Location

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