Provider Demographics
NPI:1497939078
Name:BAY AREA FAMILY WELLNESS CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:BAY AREA FAMILY WELLNESS CHIROPRACTIC CENTER
Other - Org Name:FAMILY WELLNESS CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:G
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:361-994-0052
Mailing Address - Street 1:5315 EVERHART RD STE 8
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4836
Mailing Address - Country:US
Mailing Address - Phone:361-994-0052
Mailing Address - Fax:361-814-4444
Practice Address - Street 1:5315 EVERHART RD STE 8
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4836
Practice Address - Country:US
Practice Address - Phone:361-994-0052
Practice Address - Fax:361-814-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty