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General NPI Number Information
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NPI Number | 1861567943
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Entity Type | Organization
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Legal Business Name | WELLNESS FIRST
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 742 SAINT ANDREWS BLVD
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City | CHARLESTON
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State | SC
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Zip | 29407-7169
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Country | US
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Telephone | 843-225-9933
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Fax | 843-225-9939
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Provider Business Mailing Address
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Address Line | 1836 ASHLEY RIVER RD SUITE 106
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City | CHARLESTON
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State | SC
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Zip | 29407-4781
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Country | US
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Telephone | 843-225-9933
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Fax | 843-225-9939
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Authorized Official
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Title or Position | CFO
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Name | MRS. CHARLENE MILLER
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Credential |
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Telephone | 843-225-9933
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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 | 3026
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License Number State | SC
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