Provider Demographics
NPI:1376850172
Name:WHOLE HEALTH CHIROPRACTIC AND WELLNESS CENTER, PLLC
Entity Type:Organization
Organization Name:WHOLE HEALTH CHIROPRACTIC AND WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:901-672-7308
Mailing Address - Street 1:5395 ESTATE OFFICE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-0614
Mailing Address - Country:US
Mailing Address - Phone:901-672-7308
Mailing Address - Fax:
Practice Address - Street 1:5395 ESTATE OFFICE DR STE 2
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0614
Practice Address - Country:US
Practice Address - Phone:901-672-7308
Practice Address - Fax:901-672-7327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-01
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2446111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty