Healthcare Provider Details

I. General information

NPI: 1467481820
Provider Name (Legal Business Name): MAXIMUM WELLNESS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E JEFFERSON ST.
WHEATLAND IA
52777-0070
US

IV. Provider business mailing address

PO BOX 70
WHEATLAND IA
52777-0070
US

V. Phone/Fax

Practice location:
  • Phone: 563-374-1535
  • Fax: 563-374-1145
Mailing address:
  • Phone: 563-374-1535
  • Fax: 563-374-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberA06180
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK E KALAROVICH II
Title or Position: OWNER
Credential: D. C.
Phone: 563-374-1535