Provider Demographics
NPI:1033851597
Name:WELL HEALTH SANTA ROSA BEACH LLC
Entity Type:Organization
Organization Name:WELL HEALTH SANTA ROSA BEACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:CARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-389-4303
Mailing Address - Street 1:1085 SANDGRASS BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-8863
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 MC DAVIS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-5085
Practice Address - Country:US
Practice Address - Phone:850-468-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty