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General NPI Number Information
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NPI Number | 1902970155
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Entity Type | Organization
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Legal Business Name | THE WELLNESS INSTITUTE PC
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 120 LEFANTE WAY STE 1
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City | BAYONNE
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State | NJ
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Zip | 07002-5060
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Country | US
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Telephone | 201-858-4444
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Fax | 201-858-4049
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Provider Business Mailing Address
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Address Line | 120 LEFANTE WAY STE 1
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City | BAYONNE
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State | NJ
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Zip | 07002-5060
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Country | US
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Telephone | 201-858-4444
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Fax |
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | DR. MICHAEL JOHN ACANFORA
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Credential | D.C.
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Telephone | 201-858-0444
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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 | 38MC00502900
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License Number State | NJ
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