Healthcare Provider Details

I. General information

NPI: 1114958873
Provider Name (Legal Business Name): PHYSICIANS WELLNESS CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6894 LAKE WORTH RD SUITE 104
LAKE WORTH FL
33467-2964
US

IV. Provider business mailing address

6894 LAKE WORTH RD SUITE 104
LAKE WORTH FL
33467-2964
US

V. Phone/Fax

Practice location:
  • Phone: 561-964-9191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 60439
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCH 7582
License Number StateFL

VIII. Authorized Official

Name: DR. SABRINA MORGEN
Title or Position: CLINIC DIRECTOR
Credential: DC
Phone: 561-964-9191