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General NPI Number Information
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NPI Number | 1336864800
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Entity Type | Organization
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Legal Business Name | WELLNESS WAY WESLEY CHAPEL LLC
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Dates
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Enumeration Date | 10/07/2022
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 2252 TWELVE OAKS WAY STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6972
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Country | US
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Telephone | 330-617-6863
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Fax |
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Provider Business Mailing Address
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Address Line | 2252 TWELVE OAKS WAY STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6972
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Country | US
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Telephone | 330-617-6863
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK FLYNN
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Credential | DC
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Telephone | 330-617-6863
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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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