Provider Demographics
NPI:1407618465
Name:MIDWEST WELLNESS CENTER INC
Entity Type:Organization
Organization Name:MIDWEST WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAUERNIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-222-8872
Mailing Address - Street 1:5552 W CALVEY CIR
Mailing Address - Street 2:
Mailing Address - City:CATAWISSA
Mailing Address - State:MO
Mailing Address - Zip Code:63015-1842
Mailing Address - Country:US
Mailing Address - Phone:719-344-1178
Mailing Address - Fax:
Practice Address - Street 1:4672 GRAVOIS RD
Practice Address - Street 2:
Practice Address - City:HOUSE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:63051-4343
Practice Address - Country:US
Practice Address - Phone:636-222-8872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty