Provider Demographics
NPI:1760711246
Name:FUNK CONSULTING & PROMOTIONAL SERVICES, INC.
Entity Type:Organization
Organization Name:FUNK CONSULTING & PROMOTIONAL SERVICES, INC.
Other - Org Name:INTEGRATED WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LELAND
Authorized Official - Middle Name:WELCH
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCEP, AP, DOM
Authorized Official - Phone:772-581-3773
Mailing Address - Street 1:1511 US HIGHWAY 1
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-1611
Mailing Address - Country:US
Mailing Address - Phone:772-581-3773
Mailing Address - Fax:772-581-3746
Practice Address - Street 1:1511 US HIGHWAY 1
Practice Address - Street 2:SUITE 203
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-1611
Practice Address - Country:US
Practice Address - Phone:772-581-3773
Practice Address - Fax:772-581-3746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6567111N00000X
FLAP2243171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty