Provider Demographics
NPI:1467763649
Name:PIERCE FAMILY WELLNESS CENTER P.L.L.C
Entity Type:Organization
Organization Name:PIERCE FAMILY WELLNESS CENTER P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:CIUCEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-282-9300
Mailing Address - Street 1:2530 W ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-8468
Mailing Address - Country:US
Mailing Address - Phone:704-282-9300
Mailing Address - Fax:704-282-9344
Practice Address - Street 1:2530 W ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8468
Practice Address - Country:US
Practice Address - Phone:704-282-9300
Practice Address - Fax:704-282-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty