Healthcare Provider Details

I. General information

NPI: 1598090623
Provider Name (Legal Business Name): SPRING WELLNESS AND REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 10/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 SAWDUST RD
SPRING TX
77380-2238
US

IV. Provider business mailing address

271 SAWDUST RD
SPRING TX
77380-2238
US

V. Phone/Fax

Practice location:
  • Phone: 281-419-2300
  • Fax: 281-419-2030
Mailing address:
  • Phone: 281-419-2300
  • Fax: 281-419-2030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberF007948
License Number StateTX

VIII. Authorized Official

Name: DR. LYNN MARIE MARQUARDT
Title or Position: OWNER
Credential: D.C.
Phone: 281-419-2300