Provider Demographics
NPI:1184152563
Name:WELLNESS WALK-IN TUBS LLC
Entity type:Organization
Organization Name:WELLNESS WALK-IN TUBS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-375-3044
Mailing Address - Street 1:320 N ACADEMY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-6621
Mailing Address - Country:US
Mailing Address - Phone:719-375-3044
Mailing Address - Fax:719-452-3858
Practice Address - Street 1:320 N ACADEMY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-6621
Practice Address - Country:US
Practice Address - Phone:719-375-3044
Practice Address - Fax:719-452-3858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COA170230171W00000X
CO2017126975100CL171WH0202X
CO2017126972000SL171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty