Provider Demographics
NPI:1629478680
Name:WENSINK HEALTH GROUP LLC
Entity Type:Organization
Organization Name:WENSINK HEALTH GROUP LLC
Other - Org Name:SUPERIOR SPINE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:WENSINK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-539-2315
Mailing Address - Street 1:28821 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-4013
Mailing Address - Country:US
Mailing Address - Phone:440-716-8400
Mailing Address - Fax:440-716-8401
Practice Address - Street 1:28821 LORAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-4013
Practice Address - Country:US
Practice Address - Phone:440-716-8400
Practice Address - Fax:440-716-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty