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General NPI Number Information
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NPI Number | 1578423455
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Entity Type | Organization
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Legal Business Name | NUWAVE HOLISTIC HEALTH CENTER PLLC
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 475 W TOWN PL STE 115
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-3649
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Country | US
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Telephone | 904-679-5406
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Fax | 904-679-5586
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Provider Business Mailing Address
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Address Line | 659 PORTA ROSA CIR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-0456
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Country | US
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Telephone | 412-420-9053
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Fax | 904-679-5586
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. DANIEL JACOB VISH
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Credential | DC
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Telephone | 904-679-5406
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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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