Provider Demographics
NPI:1821607268
Name:WELLMATE DR LEE CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:WELLMATE DR LEE CHIROPRACTIC CLINIC INC
Other - Org Name:WELLMATE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:213-210-8763
Mailing Address - Street 1:3948 WILSHIRE BLVD # 200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3303
Mailing Address - Country:US
Mailing Address - Phone:323-289-8601
Mailing Address - Fax:323-289-8603
Practice Address - Street 1:3948 WILSHIRE BLVD # 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3303
Practice Address - Country:US
Practice Address - Phone:323-289-8601
Practice Address - Fax:323-289-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty