MEDICARE: THE WELLNESS CENTER, 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	:	1891202909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WELLNESS CENTER, INC

Provider Business Mailing Address
First Line	:	870 S COLORADO BLVD STE 200
Second Line	:
City	:	GLENDALE
State	:	CO
Zip	:	80246-2080
Country	:	US
Telephone Number	:	303-357-9355
Fax Number	:	303-357-0261

Provider Business Practice Location Address
First Line	:	870 S COLORADO BLVD STE 200
Second Line	:
City	:	GLENDALE
State	:	CO
Zip	:	80246-2080
Country	:	US
Telephone Number	:	303-357-9355
Fax Number	:	303-357-0261

Authorized Official
Title or Position	:	OWNER
Name	:	SHARON HWANG
Credential	:
Telephone Number	:	303-357-9355

Provider Enumeration Date	:	01/10/2018
Last Update Date	:	01/10/2018

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