Provider Demographics
NPI:1225891385
Name:REDD CHIROPRACTIC & WELLNESS LLC
Entity Type:Organization
Organization Name:REDD CHIROPRACTIC & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:REDD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-769-3752
Mailing Address - Street 1:100 SENNA ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4415
Mailing Address - Country:US
Mailing Address - Phone:614-769-3752
Mailing Address - Fax:
Practice Address - Street 1:127 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8637
Practice Address - Country:US
Practice Address - Phone:614-769-3752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service