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General NPI Number Information
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NPI Number | 1811490287
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Entity Type | Organization
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Legal Business Name | C3 WELLNESS, LLC
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 395 VILLAGE DR
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City | KISSIMMEE
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State | FL
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Zip | 34759-4012
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Country | US
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Telephone | 407-914-9168
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Fax | 407-337-8005
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Provider Business Mailing Address
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Address Line | 2717 EAGLE CANYON DR S
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City | KISSIMMEE
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State | FL
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Zip | 34746-3170
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Country | US
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Telephone | 407-914-9168
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARCUS BETHEA
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Credential |
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Telephone | 919-606-6423
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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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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA58296
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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