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General NPI Number Information
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NPI Number | 1407618465
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Entity Type | Organization
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Legal Business Name | MIDWEST WELLNESS CENTER INC
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 4672 GRAVOIS RD
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City | HOUSE SPRINGS
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State | MO
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Zip | 63051-4343
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Country | US
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Telephone | 636-222-8872
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Fax |
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Provider Business Mailing Address
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Address Line | 5552 W CALVEY CIR
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City | CATAWISSA
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State | MO
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Zip | 63015-1842
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Country | US
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Telephone | 719-344-1178
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. BRITTANY JAUERNIG
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Credential | DC
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Telephone | 636-222-8872
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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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