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General NPI Number Information
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NPI Number | 1093028755
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Entity Type | Organization
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Legal Business Name | SCIENCE OF WELLNESS
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 8811 TEEL PKWY SUITE 180
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 972-704-1890
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Fax | 972-704-1891
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Provider Business Mailing Address
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Address Line | 8811 TEEL PKWY STE 180
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City | FRISCO
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State | TX
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Zip | 75034-4427
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Country | US
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Telephone | 972-704-1890
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. DOUGLAS ADAM GATEWOOD
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Credential |
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Telephone | 972-704-1890
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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 | 10591
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11587
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License Number State | TX
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