Provider Demographics
NPI:1467481820
Name:MAXIMUM WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:MAXIMUM WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:KALAROVICH
Authorized Official - Suffix:II
Authorized Official - Credentials:D C
Authorized Official - Phone:563-374-1535
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:WHEATLAND
Mailing Address - State:IA
Mailing Address - Zip Code:52777-0070
Mailing Address - Country:US
Mailing Address - Phone:563-374-1535
Mailing Address - Fax:563-374-1145
Practice Address - Street 1:110 E JEFFERSON ST.
Practice Address - Street 2:
Practice Address - City:WHEATLAND
Practice Address - State:IA
Practice Address - Zip Code:52777-0070
Practice Address - Country:US
Practice Address - Phone:563-374-1535
Practice Address - Fax:563-374-1145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06180111N00000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA71969Medicare ID - Type Unspecified