Provider Demographics
NPI:1306000112
Name:NEW VISION WELLNESS, LLC
Entity Type:Organization
Organization Name:NEW VISION WELLNESS, LLC
Other - Org Name:THE WELLNESS WAY GREENVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAGREE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-216-4699
Mailing Address - Street 1:4201 GLEN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6101
Mailing Address - Country:US
Mailing Address - Phone:502-216-4699
Mailing Address - Fax:
Practice Address - Street 1:4201 GLEN FOREST DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6101
Practice Address - Country:US
Practice Address - Phone:502-216-4699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4071111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty