Provider Demographics
NPI:1144568148
Name:CONSILIENCE INC
Entity Type:Organization
Organization Name:CONSILIENCE INC
Other - Org Name:ESSENCE OF WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:PALMER
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-456-4555
Mailing Address - Street 1:PO BOX 333
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-0333
Mailing Address - Country:US
Mailing Address - Phone:937-456-4555
Mailing Address - Fax:888-789-0151
Practice Address - Street 1:890 S BARRON ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-9362
Practice Address - Country:US
Practice Address - Phone:937-456-4555
Practice Address - Fax:888-789-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty