Provider Demographics
NPI:1902031461
Name:WELLNESS POINTE, PC
Entity Type:Organization
Organization Name:WELLNESS POINTE, PC
Other - Org Name:THE WELLNESS POINTE FAMILY CHIROPRACTIC AND LIFESTYLE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-991-4102
Mailing Address - Street 1:16909 BURKE ST
Mailing Address - Street 2:SUITE 124
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-2268
Mailing Address - Country:US
Mailing Address - Phone:402-933-4463
Mailing Address - Fax:402-763-6923
Practice Address - Street 1:16909 BURKE ST
Practice Address - Street 2:SUITE 124
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-2268
Practice Address - Country:US
Practice Address - Phone:402-933-4463
Practice Address - Fax:402-763-6923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1559111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty