Provider Demographics
NPI:1972980258
Name:ADVANCED WELLNESS SOLUTIONS LLC
Entity Type:Organization
Organization Name:ADVANCED WELLNESS SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:HURD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:855-509-5400
Mailing Address - Street 1:729 SW FEDERAL HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2913
Mailing Address - Country:US
Mailing Address - Phone:855-509-5400
Mailing Address - Fax:321-373-2062
Practice Address - Street 1:729 SW FEDERAL HWY STE 102
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2913
Practice Address - Country:US
Practice Address - Phone:855-509-5400
Practice Address - Fax:321-373-2062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty