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General NPI Number Information
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NPI Number | 1639319072
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Entity Type | Organization
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Legal Business Name | ABUNDANT WELLNESS, INC.
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 4940 CAPITAL BLVD BLDG B
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City | RALEIGH
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State | NC
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Zip | 27616-4491
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Country | US
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Telephone | 919-787-8276
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Fax | 919-787-8276
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Provider Business Mailing Address
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Address Line | 3434 EDWARDS MILL RD SUITE 112-275
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City | RALEIGH
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State | NC
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Zip | 27612-4275
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Country | US
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Telephone | 919-787-8276
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Fax | 919-787-8276
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARTHUR FREDERICK KENNEDY
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Credential | D.C.
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Telephone | 919-787-8276
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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 | 1584
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License Number State | NC
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