Healthcare Provider Details
I. General information
NPI: 1982936985
Provider Name (Legal Business Name): WELLNESS SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2010
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 HOSPITAL CENTER CMNS STE 200A
HILTON HEAD ISLAND SC
29926-2840
US
IV. Provider business mailing address
200 CENTRAL AVE SUITE B
HILTON HEAD ISLAND SC
29926-1635
US
V. Phone/Fax
- Phone: 843-686-9355
- Fax: 843-686-9354
- Phone: 843-686-9355
- Fax: 843-686-9354
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2837 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2565 |
| License Number State | SC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2003 |
| License Number State | SC |
VIII. Authorized Official
Name:
DAVID
WASHACK
Title or Position: OWNER
Credential: D.C.
Phone: 843-686-9355