Provider Demographics
NPI:1295298230
Name:WELLNESS ASSOCIATES ONE LLC
Entity type:Organization
Organization Name:WELLNESS ASSOCIATES ONE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILBECK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-500-8700
Mailing Address - Street 1:3743 N ROCK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1386
Mailing Address - Country:US
Mailing Address - Phone:316-500-8700
Mailing Address - Fax:316-558-8902
Practice Address - Street 1:5800 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2840
Practice Address - Country:US
Practice Address - Phone:316-946-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty