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General NPI Number Information
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NPI Number | 1497593933
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Entity Type | Organization
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Legal Business Name | WEND WELLNESS LLC
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Dates
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Enumeration Date | 07/18/2024
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 21 MAIN ST
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City | STONY BROOK
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State | NY
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Zip | 11790-1901
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Country | US
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Telephone | 631-485-3643
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Fax | 631-485-3643
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Provider Business Mailing Address
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Address Line | 21 MAIN ST
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City | STONY BROOK
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State | NY
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Zip | 11790-1901
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Country | US
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Telephone | 631-485-3643
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Fax | 631-485-3643
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHANE WEND
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Credential | D.C
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Telephone | 631-485-3643
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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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