Provider Demographics
NPI:1972728004
Name:HOLISTIC HEALTH AND WELLNESS PC
Entity Type:Organization
Organization Name:HOLISTIC HEALTH AND WELLNESS PC
Other - Org Name:CHIROPRACTIC AND HOLISTIC WELLNESS PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RUTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-265-2522
Mailing Address - Street 1:645 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1429
Mailing Address - Country:US
Mailing Address - Phone:610-265-2522
Mailing Address - Fax:610-265-3506
Practice Address - Street 1:645 CLARK AVE
Practice Address - Street 2:645
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1429
Practice Address - Country:US
Practice Address - Phone:610-265-2522
Practice Address - Fax:610-265-3506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty