Provider Demographics
NPI:1669926465
Name:WELLSPRING CHIROPRACTIC CENTER, LLC
Entity type:Organization
Organization Name:WELLSPRING CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-704-6389
Mailing Address - Street 1:727 E CANAL ST
Mailing Address - Street 2:
Mailing Address - City:NELSONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45764-1378
Mailing Address - Country:US
Mailing Address - Phone:740-753-4949
Mailing Address - Fax:
Practice Address - Street 1:727 E CANAL ST
Practice Address - Street 2:
Practice Address - City:NELSONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45764-1378
Practice Address - Country:US
Practice Address - Phone:740-753-4949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4585111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty