Provider Demographics
NPI:1700575255
Name:M & A WELLNESS PLLC
Entity Type:Organization
Organization Name:M & A WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAYCHOUNI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:313-718-0783
Mailing Address - Street 1:4305 W 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6504
Mailing Address - Country:US
Mailing Address - Phone:248-951-8927
Mailing Address - Fax:248-951-8937
Practice Address - Street 1:4305 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6504
Practice Address - Country:US
Practice Address - Phone:248-951-8927
Practice Address - Fax:248-951-8937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty