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General NPI Number Information
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NPI Number | 1922279686
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Entity Type | Organization
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Legal Business Name | JOLLY WAY HEALTH INC., P.S. DBA MERCER WELLNESS
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 7605 SE 27TH ST STE 103
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City | MERCER ISLAND
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State | WA
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Zip | 98040-2835
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Country | US
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Telephone | 206-275-4870
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Fax | 206-275-4876
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Provider Business Mailing Address
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Address Line | 7605 SE 27TH ST STE 103
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City | MERCER ISLAND
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State | WA
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Zip | 98040-2835
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Country | US
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Telephone | 206-275-4870
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Fax | 206-275-4876
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. FARRELL E JOLLY
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Credential | D.C.
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Telephone | 206-275-4870
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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 | CH00034804
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License Number State | WA
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