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General NPI Number Information
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NPI Number | 1548578347
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Entity Type | Organization
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Legal Business Name | WELLNESSFIRST CHIROPRACTIC OF ELLETTSVILLE LLC
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Dates
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Enumeration Date | 09/15/2010
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 5935 W STATE ROAD 46
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City | BLOOMINGTON
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State | IN
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Zip | 47404-9359
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Country | US
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Telephone | 812-268-3237
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Fax |
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Provider Business Mailing Address
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Address Line | 5935 W STATE ROAD 46
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City | BLOOMINGTON
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State | IN
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Zip | 47404-9359
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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 | BILLING MANAGER
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Name | CARRIE J WEBSTER
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Credential |
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Telephone | 812-268-3237
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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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