Provider Demographics
NPI:1568079093
Name:ABRAHAMSON CHIROPRACTIC AND WELLNESS
Entity Type:Organization
Organization Name:ABRAHAMSON CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-617-0734
Mailing Address - Street 1:165 INDIAN LAKE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6216
Mailing Address - Country:US
Mailing Address - Phone:615-826-7889
Mailing Address - Fax:
Practice Address - Street 1:165 INDIAN LAKE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6216
Practice Address - Country:US
Practice Address - Phone:615-826-7889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty