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General NPI Number Information
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NPI Number | 1497595177
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Entity Type | Organization
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Legal Business Name | WELLNESS SOCIETY LLC
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 17749 65TH AVE
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City | TINLEY PARK
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State | IL
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Zip | 60477-4370
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Country | US
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Telephone | 708-670-2576
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Fax |
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Provider Business Mailing Address
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Address Line | 17749 65TH AVE
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City | TINLEY PARK
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State | IL
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Zip | 60477-4370
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. BRANDON KORFEL
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Credential | DC
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Telephone | 586-350-6606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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