Provider Demographics
NPI:1952678385
Name:INTEGRATED WELLNESS CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:INTEGRATED WELLNESS CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:TURINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-273-1445
Mailing Address - Street 1:148 W WASHINGTON ST
Mailing Address - Street 2:SUITE M-3
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4383
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:148 W WASHINGTON ST
Practice Address - Street 2:SUITE M-3
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4383
Practice Address - Country:US
Practice Address - Phone:906-273-1445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1649443268Medicare NSC