MEDICARE: WELLNESS HEALTH CHOICE, 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	305S00000X	Point of Service	1823	MA
2	111N00000X	Chiropractor	1823	MA

General Provider Information

NPI Number	:	1265602023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS HEALTH CHOICE, LLC

Provider Business Mailing Address
First Line	:	WELLNESS HEALTH CHOICE, LLC
Second Line	:	118 WASHINGTON STREET SUITE 27
City	:	HOLLISTON
State	:	MA
Zip	:	01746-1373
Country	:	US
Telephone Number	:	508-429-8003
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 WASHINGTON STREET
Second Line	:	SUITE 27
City	:	HOLLISTON
State	:	MA
Zip	:	01746-1373
Country	:	US
Telephone Number	:	508-429-8003
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LISA WOOD
Credential	:	D.C.
Telephone Number	:	413-896-7737

Provider Enumeration Date	:	03/08/2008
Last Update Date	:	04/16/2018

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