Provider Demographics
NPI:1972900306
Name:OSWALD CHIROPRACTIC & WELLNESS LLC
Entity Type:Organization
Organization Name:OSWALD CHIROPRACTIC & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHNATHON
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-748-1903
Mailing Address - Street 1:823 CHEYENNE MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4929
Mailing Address - Country:US
Mailing Address - Phone:719-268-0708
Mailing Address - Fax:
Practice Address - Street 1:823 CHEYENNE MEADOWS RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4929
Practice Address - Country:US
Practice Address - Phone:719-268-0708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty