Provider Demographics
NPI:1619149408
Name:CHIROWERKS WELLNESS & REHABILITATION, P.A.
Entity Type:Organization
Organization Name:CHIROWERKS WELLNESS & REHABILITATION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:GOODSPEED
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-442-7213
Mailing Address - Street 1:2101 REXFORD RD
Mailing Address - Street 2:SUITE 50W
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3477
Mailing Address - Country:US
Mailing Address - Phone:704-442-7213
Mailing Address - Fax:704-442-7214
Practice Address - Street 1:2101 REXFORD RD
Practice Address - Street 2:SUITE 50W
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3477
Practice Address - Country:US
Practice Address - Phone:704-442-7213
Practice Address - Fax:704-442-7214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3852111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty