Provider Demographics
NPI:1003834870
Name:WELLNESSONE OF WARREN
Entity Type:Organization
Organization Name:WELLNESSONE OF WARREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHETSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-543-2097
Mailing Address - Street 1:1553 NILES CORTLAND RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-3073
Mailing Address - Country:US
Mailing Address - Phone:330-505-3515
Mailing Address - Fax:330-505-3552
Practice Address - Street 1:1553 NILES CORTLAND RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-3073
Practice Address - Country:US
Practice Address - Phone:330-505-3515
Practice Address - Fax:330-505-3552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty