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General NPI Number Information
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NPI Number | 1063983583
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Entity Type | Organization
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Legal Business Name | INTEGRATED WELLNESS LLC
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Dates
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Enumeration Date | 12/10/2018
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 280 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32502-4841
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Country | US
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Telephone | 850-637-5281
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 BAY POINTE DR
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City | GULF BREEZE
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State | FL
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Zip | 32563-2916
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Country | US
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Telephone | 314-779-9740
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT THOMSON JR.
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Credential | DC
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Telephone | 850-637-5281
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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 |
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License Number State |
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