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General NPI Number Information
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NPI Number | 1912430786
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Entity Type | Organization
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Legal Business Name | WELLNESS WAY MOUNT PLEASANT LLC
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 07/06/2017
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Provider Practice Location Address
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Address Line | 1639 E BROOMFIELD ST STE E
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-5433
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Country | US
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Telephone | 989-944-1997
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Fax |
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Provider Business Mailing Address
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Address Line | 1639 E BROOMFIELD ST STE E
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-5433
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK FLYNN
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Credential | DC
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Telephone | 920-660-7877
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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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