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NPI Code Detail

MEDICARE: OMNI WELLNESS CENTER PLLC

MEDICARE: OMNI WELLNESS CENTER 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
1111N00000XChiropractor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639350770
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMNI WELLNESS CENTER PLLC
Provider Business Mailing Address
First Line : 10220 COULOAK DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-7678
Country : US
Telephone Number : 704-392-9999
Fax Number : 704-392-9913
Provider Business Practice Location Address
First Line : 10220 COULOAK DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-7678
Country : US
Telephone Number : 704-392-9999
Fax Number : 704-392-9913
Authorized Official
Title or Position : OWNER
Name : TYSHIA ALLEN
Credential : DC
Telephone Number : 704-392-9999
Provider Enumeration Date : 11/16/2007
Last Update Date : 12/10/2025

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1366999476 — DR. REBECCA ANN MILLER D.C.
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28216-7678
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28216-7678
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1861264111 — DR. SEANIA OVERTON DC
Practice Location Address:
10220 COULOAK DR
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28216-7678
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Practice Fax: 704-392-9913

Directions to “OMNI WELLNESS CENTER PLLC ” Practice Location

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