Provider Demographics
NPI:1437774031
Name:TRANSFORMATION WELLNESS CENTER
Entity Type:Organization
Organization Name:TRANSFORMATION WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:660-460-6283
Mailing Address - Street 1:104 E MCPHERSON ST
Mailing Address - Street 2:
Mailing Address - City:KNOB NOSTER
Mailing Address - State:MO
Mailing Address - Zip Code:65336-1325
Mailing Address - Country:US
Mailing Address - Phone:660-460-6283
Mailing Address - Fax:
Practice Address - Street 1:104 E MCPHERSON ST
Practice Address - Street 2:
Practice Address - City:KNOB NOSTER
Practice Address - State:MO
Practice Address - Zip Code:65336-1325
Practice Address - Country:US
Practice Address - Phone:660-460-6283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty