Provider Demographics
NPI:1982835880
Name:SUSTAINABLE ENTERPRISES INC
Entity Type:Organization
Organization Name:SUSTAINABLE ENTERPRISES INC
Other - Org Name:WISDOM OF WELLNESS AND CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-673-3276
Mailing Address - Street 1:725 SE MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-3938
Mailing Address - Country:US
Mailing Address - Phone:541-673-3276
Mailing Address - Fax:541-673-2831
Practice Address - Street 1:725 SE MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-3938
Practice Address - Country:US
Practice Address - Phone:541-673-3276
Practice Address - Fax:541-673-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28-2306261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1316190853OtherPERSONAL NPI NUMBER