Provider Demographics
NPI:1114431491
Name:WELLNESS WAY WESTMINSTER LLC
Entity Type:Organization
Organization Name:WELLNESS WAY WESTMINSTER LLC
Other - Org Name:WELLNESS WAY LOUISVILLE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-429-2844
Mailing Address - Street 1:12050 PECOS ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2080
Mailing Address - Country:US
Mailing Address - Phone:720-379-7255
Mailing Address - Fax:
Practice Address - Street 1:12050 PECOS ST STE 208
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2080
Practice Address - Country:US
Practice Address - Phone:720-379-7255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-26
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty