Provider Demographics
NPI:1073998340
Name:AFFINITY HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:AFFINITY HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-991-7731
Mailing Address - Street 1:2261 PYRAMID WAY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-2189
Mailing Address - Country:US
Mailing Address - Phone:775-358-3590
Mailing Address - Fax:775-358-3844
Practice Address - Street 1:2261 PYRAMID WAY
Practice Address - Street 2:SUITE 5
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-2189
Practice Address - Country:US
Practice Address - Phone:775-358-3590
Practice Address - Fax:775-358-3844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB015012111N00000X
CADC 28823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty