Provider Demographics
NPI:1396014239
Name:NEWEDGE WELLNESS CENTER PS
Entity Type:Organization
Organization Name:NEWEDGE WELLNESS CENTER PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-737-9355
Mailing Address - Street 1:3001 W 10TH AVE
Mailing Address - Street 2:STE A101
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-5019
Mailing Address - Country:US
Mailing Address - Phone:509-737-9355
Mailing Address - Fax:509-735-4277
Practice Address - Street 1:3001 W 10TH AVE
Practice Address - Street 2:STE A101
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5019
Practice Address - Country:US
Practice Address - Phone:509-737-9355
Practice Address - Fax:509-735-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60211304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty