Provider Demographics
NPI:1164090445
Name:INTEGRATIVE WELLNESS ASSOCIATES
Entity Type:Organization
Organization Name:INTEGRATIVE WELLNESS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:WARNINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-644-8120
Mailing Address - Street 1:1619 N 9TH ST STE 10
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-6501
Mailing Address - Country:US
Mailing Address - Phone:570-664-8120
Mailing Address - Fax:570-664-8128
Practice Address - Street 1:1619 N 9TH ST STE 10
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-6501
Practice Address - Country:US
Practice Address - Phone:570-664-8120
Practice Address - Fax:570-664-8128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty