Healthcare Provider Details

I. General information

NPI: 1265602023
Provider Name (Legal Business Name): WELLNESS HEALTH CHOICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2008
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 WASHINGTON STREET SUITE 27
HOLLISTON MA
01746-1373
US

IV. Provider business mailing address

WELLNESS HEALTH CHOICE, LLC 118 WASHINGTON STREET SUITE 27
HOLLISTON MA
01746-1373
US

V. Phone/Fax

Practice location:
  • Phone: 508-429-8003
  • Fax:
Mailing address:
  • Phone: 508-429-8003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1823
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number1823
License Number StateMA

VIII. Authorized Official

Name: DR. LISA WOOD
Title or Position: OWNER
Credential: D.C.
Phone: 413-896-7737