Provider Demographics
NPI:1720385636
Name:KULOW CHIROPRACTIC & WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:KULOW CHIROPRACTIC & WELLNESS CENTER PLLC
Other - Org Name:KELLIE KULOW, D.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KULOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:979-830-7055
Mailing Address - Street 1:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77834-0321
Mailing Address - Country:US
Mailing Address - Phone:979-830-7055
Mailing Address - Fax:979-353-5544
Practice Address - Street 1:218 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-3780
Practice Address - Country:US
Practice Address - Phone:979-830-7055
Practice Address - Fax:979-353-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-12
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
TX9361261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043229032OtherNPI