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General NPI Number Information
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NPI Number | 1902327547
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Entity Type | Organization
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Legal Business Name | WELLNESS CENTERS, PLLC
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11133 FRANCE AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55431-3857
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Country | US
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Telephone | 612-545-7099
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Fax |
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Provider Business Mailing Address
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Address Line | 11133 FRANCE AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55431-3857
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Country | US
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Telephone | 612-545-7099
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW MYERS
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Credential | DC
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Telephone | 612-545-7099
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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 | 6371
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License Number State | MN
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