Provider Demographics
NPI:1083700918
Name:WELLNESS CARE CHIROPRACTIC
Entity Type:Organization
Organization Name:WELLNESS CARE CHIROPRACTIC
Other - Org Name:DR GRANT STOWELL DC
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:A
Authorized Official - Last Name:STOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-712-0200
Mailing Address - Street 1:9555 LEBONON RD 801
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035
Mailing Address - Country:US
Mailing Address - Phone:972-712-0200
Mailing Address - Fax:972-712-2303
Practice Address - Street 1:9555 LEBANON RD 801
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:972-712-0200
Practice Address - Fax:972-712-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U79000Medicare UPIN
609363Medicare ID - Type Unspecified