Healthcare Provider Details

I. General information

NPI: 1730237801
Provider Name (Legal Business Name): MICHAEL WELLS NEELY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2413 PACIFIC AVE SE STE A
OLYMPIA WA
98501-2087
US

IV. Provider business mailing address

PO BOX 700688
SAN ANTONIO TX
78270-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-404-6050
  • Fax: 866-313-3397
Mailing address:
  • Phone: 210-318-3007
  • Fax: 210-468-0682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH00034084
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: