Provider Demographics
NPI:1568932556
Name:ADVANCED WHOLISTIC HEALTHCARE LLC
Entity Type:Organization
Organization Name:ADVANCED WHOLISTIC HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUPERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:650-219-8851
Mailing Address - Street 1:5537 N MILITARY TRL APT 1905
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-3497
Mailing Address - Country:US
Mailing Address - Phone:650-219-8851
Mailing Address - Fax:
Practice Address - Street 1:5537 N MILITARY TRL APT 1905
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-3497
Practice Address - Country:US
Practice Address - Phone:650-219-8851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty