Provider Demographics
NPI:1508119116
Name:COMPLETE WELLNESS P.A.
Entity Type:Organization
Organization Name:COMPLETE WELLNESS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-737-7334
Mailing Address - Street 1:3379 W. WOOLBRIGHT ROAD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-7245
Mailing Address - Country:US
Mailing Address - Phone:561-737-7334
Mailing Address - Fax:561-336-3097
Practice Address - Street 1:3379 W. WOOLBRIGHT ROAD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-7245
Practice Address - Country:US
Practice Address - Phone:561-737-7334
Practice Address - Fax:561-336-3092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH-10675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty