MEDICARE: WORLD OF WELLNESS HEALTH CENTERS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1083916829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WORLD OF WELLNESS HEALTH CENTERS, INC

Provider Business Mailing Address
First Line	:	PO BOX 150778
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-0778
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4925 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-1407
Country	:	US
Telephone Number	:	817-456-9803
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MIA K MEYER
Credential	:
Telephone Number	:	817-456-9803

Provider Enumeration Date	:	11/30/2010
Last Update Date	:	11/30/2010

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