MEDICARE: K AND S WELLNESS LLC

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	4340	NC
2	111N00000X	Chiropractor	4343	NC

General Provider Information

NPI Number	:	1134468440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K AND S WELLNESS LLC

Provider Business Mailing Address
First Line	:	4016 WIGGINS RD
Second Line	:
City	:	YOUNGSVILLE
State	:	NC
Zip	:	27596-9405
Country	:	US
Telephone Number	:	919-802-7234
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 DR CALVIN JONES HWY
Second Line	:	SUITE 104
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-3100
Country	:	US
Telephone Number	:	919-761-5158
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. SHERRI RALEY
Credential	:	DC
Telephone Number	:	919-802-7234

Provider Enumeration Date	:	02/06/2013
Last Update Date	:	04/10/2013

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Directions to “K AND S WELLNESS LLC ” Practice Location

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