Provider Demographics
NPI:1861648834
Name:WELLNESS SOLUTIONS PC
Entity Type:Organization
Organization Name:WELLNESS SOLUTIONS PC
Other - Org Name:FARGO SPINE AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:P
Authorized Official - Last Name:VEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-232-4770
Mailing Address - Street 1:2800 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103
Mailing Address - Country:US
Mailing Address - Phone:701-232-4770
Mailing Address - Fax:701-237-3251
Practice Address - Street 1:2800 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103
Practice Address - Country:US
Practice Address - Phone:701-232-4770
Practice Address - Fax:701-237-3251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13552Medicaid
NDV06143Medicare UPIN