Provider Demographics
NPI:1568636520
Name:THE HEALTH & WELLNESS CLINIC OF CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:THE HEALTH & WELLNESS CLINIC OF CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCHENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-818-7373
Mailing Address - Street 1:6921 PISTOL RANGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-9613
Mailing Address - Country:US
Mailing Address - Phone:813-818-7373
Mailing Address - Fax:813-818-7332
Practice Address - Street 1:6921 PISTOL RANGE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9613
Practice Address - Country:US
Practice Address - Phone:813-818-7373
Practice Address - Fax:813-818-7332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9486261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service