Healthcare Provider Details

I. General information

NPI: 1548061757
Provider Name (Legal Business Name): METRO WELLNESS CHIROPRACTIC PHYSICAL THERAPY AND MASSAGE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 W 48TH ST STE 608
NEW YORK NY
10036-1708
US

IV. Provider business mailing address

64 W 48TH ST STE 608
NEW YORK NY
10036-1708
US

V. Phone/Fax

Practice location:
  • Phone: 716-550-1792
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RAELA WILEY
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 716-550-1792