Provider Demographics
NPI:1255617106
Name:WELLNESS CENTERS OF AMERICA, INC.
Entity type:Organization
Organization Name:WELLNESS CENTERS OF AMERICA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEWERT
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:404-259-8064
Mailing Address - Street 1:6470 E JOHNS XING
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2511
Mailing Address - Country:US
Mailing Address - Phone:678-802-4958
Mailing Address - Fax:888-774-0456
Practice Address - Street 1:13057 HIGHWAY 9 N
Practice Address - Street 2:SUITE 230
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-5139
Practice Address - Country:US
Practice Address - Phone:770-619-5366
Practice Address - Fax:770-619-5367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty