Healthcare Provider Details

I. General information

NPI: 1003239427
Provider Name (Legal Business Name): WELLNESS SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2014
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210. E CLARK AVENUE SUITE A
SANTA MARIA CA
93455
US

IV. Provider business mailing address

210. E CLARK AVENUE SUITE A
SANTA MARIA CA
93455
US

V. Phone/Fax

Practice location:
  • Phone: 805-934-5761
  • Fax: 805-937-1820
Mailing address:
  • Phone: 805-934-5761
  • Fax: 805-937-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC17888
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY LAYTON ANDERSON
Title or Position: PRESIDENT
Credential: DC
Phone: 805-934-5761