Provider Demographics
NPI:1396503108
Name:CHIRO FIRST WELLNESS CLINIC
Entity type:Organization
Organization Name:CHIRO FIRST WELLNESS CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SOOJIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-416-1688
Mailing Address - Street 1:109 BARTLETT DR
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1448
Mailing Address - Country:US
Mailing Address - Phone:787-672-5252
Mailing Address - Fax:
Practice Address - Street 1:752 N BETHLEHEM PIKE UNIT D
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2650
Practice Address - Country:US
Practice Address - Phone:267-400-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty