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General NPI Number Information
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NPI Number | 1063609907
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Entity Type | Organization
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Legal Business Name | DEAN WELLNESS CENTER LLC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 3535 MILITARY TRL STE 100
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City | JUPITER
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State | FL
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Zip | 33458-2779
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Country | US
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Telephone | 561-427-6054
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Fax | 561-427-6019
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Provider Business Mailing Address
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Address Line | 3535 MILITARY TRL STE 100
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City | JUPITER
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State | FL
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Zip | 33458-2779
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Country | US
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Telephone | 561-427-6054
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Fax | 561-427-6019
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS MICHAEL DEAN JR.
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Credential | DC
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Telephone | 561-427-6054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8408
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License Number State | FL
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