MEDICARE: UNITED WELLNESS CENTER OF LANSING PLLC

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	:	1528353588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED WELLNESS CENTER OF LANSING PLLC

Provider Business Mailing Address
First Line	:	3333 S PENNSYLVANIA AVE
Second Line	:	SUITE 101
City	:	LANSING
State	:	MI
Zip	:	48910-4795
Country	:	US
Telephone Number	:	877-881-4696
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 S PENNSYLVANIA AVE
Second Line	:	SUITE 101
City	:	LANSING
State	:	MI
Zip	:	48910-4795
Country	:	US
Telephone Number	:	877-881-4696
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ELAINE CHEFAN
Credential	:
Telephone Number	:	877-881-4696

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	07/25/2011

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