Healthcare Provider Details

I. General information

NPI: 1912597923
Provider Name (Legal Business Name): WESTOWN WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2021
Last Update Date: 01/23/2021
Certification Date: 01/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 PATRIOT DRIVE SUITE 105
MIDDLETOWN DE
19709-8506
US

IV. Provider business mailing address

1536 KIRKWOOD HIGHWAY
NEWARK DE
19711-5716
US

V. Phone/Fax

Practice location:
  • Phone: 302-828-0048
  • Fax: 302-828-0042
Mailing address:
  • Phone: 302-454-1230
  • Fax: 302-454-5855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: STACY SCOTT COHEN
Title or Position: OWNER/CHIROPRACTIC PHYSICIAN
Credential: DC
Phone: 302-454-1230