Provider Demographics
NPI:1043858962
Name:BE WELL CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BE WELL CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOLLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RADIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-422-4979
Mailing Address - Street 1:9400 PLUM DR STE 140
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-6242
Mailing Address - Country:US
Mailing Address - Phone:515-422-4979
Mailing Address - Fax:
Practice Address - Street 1:9400 PLUM DR STE 140
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-6242
Practice Address - Country:US
Practice Address - Phone:515-422-4979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty