Provider Demographics
NPI:1114184181
Name:CS WELLNESS, LLC
Entity Type:Organization
Organization Name:CS WELLNESS, LLC
Other - Org Name:BEAR MOUNTAIN CHIROPRACTIC & HEALING ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HATTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:907-688-3688
Mailing Address - Street 1:PO BOX 670848
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-0848
Mailing Address - Country:US
Mailing Address - Phone:907-688-3688
Mailing Address - Fax:907-688-3687
Practice Address - Street 1:20775 OLD GLENN HIGHWAY
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567
Practice Address - Country:US
Practice Address - Phone:907-688-3688
Practice Address - Fax:907-688-3687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCH0131Medicaid
AKCH0131Medicaid