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General NPI Number Information
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NPI Number | 1114802303
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Entity Type | Organization
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Legal Business Name | CORE WELLNESS COMPANY LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 903 DUKES ST STE 5
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City | SAINT GEORGE
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State | SC
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Zip | 29477-2095
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Country | US
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Telephone | 336-413-7331
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Fax |
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Provider Business Mailing Address
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Address Line | 1664 SAINT MARK BOWMAN RD
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City | SAINT GEORGE
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State | SC
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Zip | 29477-8837
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Country | US
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Telephone | 336-413-7331
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT, OWNER
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Name | JANA M CHINNERS
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Credential | PA-C
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Telephone | 336-413-7331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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