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General NPI Number Information
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NPI Number | 1154073302
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Entity Type | Organization
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Legal Business Name | NEUROLOGIC WELLNESS INSTITUTE PLLC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 7700 CAMINO REAL STE 320
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City | BOCA RATON
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State | FL
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Zip | 33433-5576
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Country | US
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Telephone | 908-418-0721
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Fax |
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Provider Business Mailing Address
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Address Line | 7623 NW 122ND DR
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City | PARKLAND
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State | FL
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Zip | 33076-4542
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Country | US
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Telephone | 908-418-0721
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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. KELSEY BRENNER
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Credential | DC, DACNB
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Telephone | 908-418-0721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number |
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License Number State |
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