Healthcare Provider Details
I. General information
NPI: 1053680355
Provider Name (Legal Business Name): UNITED WELLNESS CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2011
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2329 STONEBRIDGE DR BLDG E
FLINT MI
48532-5407
US
IV. Provider business mailing address
750 S OLD WOODWARD AVE
BIRMINGHAM MI
48009-6600
US
V. Phone/Fax
- Phone: 810-471-4280
- Fax: 810-355-2277
- Phone: 248-792-6570
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | MI |
VIII. Authorized Official
Name:
SILVIO
COZZETTO
Title or Position: PRESIDENT
Credential: D.C.
Phone: 248-792-6570