Provider Demographics
NPI:1356494744
Name:QUANTUM WELLNESS, INC.
Entity Type:Organization
Organization Name:QUANTUM WELLNESS, INC.
Other - Org Name:COLEMAN CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARROD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-667-1171
Mailing Address - Street 1:520 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-7901
Mailing Address - Country:US
Mailing Address - Phone:770-667-1171
Mailing Address - Fax:770-667-0801
Practice Address - Street 1:520 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-7901
Practice Address - Country:US
Practice Address - Phone:770-667-1171
Practice Address - Fax:770-667-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty