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General NPI Number Information
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NPI Number | 1205668316
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Entity Type | Organization
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Legal Business Name | 4 WELLNESS LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 08/16/2024
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 115 SUNDANCE PKWY STE 505
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City | ROUND ROCK
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State | TX
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Zip | 78681-7927
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Country | US
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Telephone | 512-985-1115
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Fax | 512-368-2580
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Provider Business Mailing Address
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Address Line | 2110 RR 620 S UNIT 341825
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City | LAKEWAY
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State | TX
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Zip | 78734-0274
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Country | US
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Telephone | 512-553-5186
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Fax | 512-368-2580
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Authorized Official
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Title or Position | OWNER
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Name | CHUCK COHN
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Credential |
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Telephone | 512-985-1115
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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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