Provider Demographics
NPI:1184819880
Name:WINNER WELLNESS CENTER
Entity Type:Organization
Organization Name:WINNER WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:WINNER
Authorized Official - Suffix:
Authorized Official - Credentials:D,C
Authorized Official - Phone:770-536-6600
Mailing Address - Street 1:746 GREEN ST NE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3322
Mailing Address - Country:US
Mailing Address - Phone:770-536-6600
Mailing Address - Fax:770-536-3923
Practice Address - Street 1:746 GREEN ST NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3322
Practice Address - Country:US
Practice Address - Phone:770-536-6600
Practice Address - Fax:770-536-3923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9057133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty