Provider Demographics
NPI:1659671915
Name:INLINE WELLNESS GROUP, INC.
Entity Type:Organization
Organization Name:INLINE WELLNESS GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-895-3000
Mailing Address - Street 1:PO BOX 670308
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-0006
Mailing Address - Country:US
Mailing Address - Phone:954-491-4437
Mailing Address - Fax:954-491-4492
Practice Address - Street 1:959 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3297
Practice Address - Country:US
Practice Address - Phone:954-491-4437
Practice Address - Fax:954-491-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty