Provider Demographics
NPI:1295940187
Name:WELLNESS HEALTH ASSOCIATES, P.C.
Entity type:Organization
Organization Name:WELLNESS HEALTH ASSOCIATES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-776-8230
Mailing Address - Street 1:PO BOX 2802
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86302-2802
Mailing Address - Country:US
Mailing Address - Phone:928-776-8230
Mailing Address - Fax:928-776-1334
Practice Address - Street 1:347 S MONTEZUMA ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-4221
Practice Address - Country:US
Practice Address - Phone:928-776-8230
Practice Address - Fax:928-776-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ76686Medicare ID - Type UnspecifiedCHIROPRACTIC