Provider Demographics
NPI:1356741805
Name:YELLOW WELLNESS CORPORATION
Entity type:Organization
Organization Name:YELLOW WELLNESS CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-644-0778
Mailing Address - Street 1:210 CENTRAL EXPY S STE 95
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8056
Mailing Address - Country:US
Mailing Address - Phone:214-644-0778
Mailing Address - Fax:972-747-1114
Practice Address - Street 1:210 CENTRAL EXPY S STE 95
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8056
Practice Address - Country:US
Practice Address - Phone:214-644-0778
Practice Address - Fax:972-747-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty