Provider Demographics
NPI:1821672635
Name:ONALASKA WELLNESS CENTER
Entity Type:Organization
Organization Name:ONALASKA WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENNAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:512-525-5185
Mailing Address - Street 1:600 3RD ST N STE 100
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-6299
Mailing Address - Country:US
Mailing Address - Phone:608-313-4327
Mailing Address - Fax:
Practice Address - Street 1:600 3RD ST N STE 100
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-6299
Practice Address - Country:US
Practice Address - Phone:608-313-4327
Practice Address - Fax:608-644-5275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty