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General NPI Number Information
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NPI Number | 1184152563
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Entity Type | Organization
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Legal Business Name | WELLNESS WALK-IN TUBS LLC
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 320 N ACADEMY BLVD STE 102
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-6621
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Country | US
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Telephone | 719-375-3044
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Fax | 719-452-3858
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Provider Business Mailing Address
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Address Line | 320 N ACADEMY BLVD STE 102
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-6621
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Country | US
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Telephone | 719-375-3044
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Fax | 719-452-3858
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Authorized Official
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Title or Position | OWNER
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Name | MR. SEAN MICHAEL WELCH
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Credential |
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Telephone | 719-375-3044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | A170230
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | 2017126975100CL
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | 2017126972000SL
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License Number State | CO
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