Provider Demographics
NPI:1053071779
Name:ABC WELLNESS, LLC
Entity Type:Organization
Organization Name:ABC WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-376-1320
Mailing Address - Street 1:2202 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3473
Mailing Address - Country:US
Mailing Address - Phone:352-376-1320
Mailing Address - Fax:
Practice Address - Street 1:2202 NW 12TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3473
Practice Address - Country:US
Practice Address - Phone:352-376-1320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305S00000XManaged Care OrganizationsPoint of Service
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty