Provider Demographics
NPI:1417092065
Name:WELLS, LINDA CHINNICI (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:CHINNICI
Last Name:WELLS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:CHINNINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 1211
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936
Mailing Address - Country:US
Mailing Address - Phone:843-726-5990
Mailing Address - Fax:
Practice Address - Street 1:124 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936
Practice Address - Country:US
Practice Address - Phone:843-726-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U457470281Medicare ID - Type Unspecified