Provider Demographics
NPI:1538316898
Name:CENTER FOR CHIROPRACTIC & WELLNESS
Entity Type:Organization
Organization Name:CENTER FOR CHIROPRACTIC & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MENDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-884-7600
Mailing Address - Street 1:5457 POST RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3024
Mailing Address - Country:US
Mailing Address - Phone:401-884-7600
Mailing Address - Fax:
Practice Address - Street 1:5457 POST RD
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3024
Practice Address - Country:US
Practice Address - Phone:401-884-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty