Provider Demographics
NPI:1659770477
Name:WAY TO WELLNESS,INC
Entity Type:Organization
Organization Name:WAY TO WELLNESS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:PELAR
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-798-9802
Mailing Address - Street 1:644 STATESVILLE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2281
Mailing Address - Country:US
Mailing Address - Phone:704-798-9802
Mailing Address - Fax:704-310-5715
Practice Address - Street 1:644 STATESVILLE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144
Practice Address - Country:US
Practice Address - Phone:704-798-9802
Practice Address - Fax:704-798-9802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-18
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2457116BMedicare PIN