Provider Demographics
NPI:1720242290
Name:WEXFORD WELLNESS CHIROPRACTIC, ACUPUNCTURE, REHAB, & ENERGY INC.
Entity Type:Organization
Organization Name:WEXFORD WELLNESS CHIROPRACTIC, ACUPUNCTURE, REHAB, & ENERGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-454-2122
Mailing Address - Street 1:2630 BRANDT SCHOOL RD
Mailing Address - Street 2:SUITE 5 FRANKLIN VILLAGE
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7646
Mailing Address - Country:US
Mailing Address - Phone:724-935-4300
Mailing Address - Fax:724-935-4321
Practice Address - Street 1:2630 BRANDT SCHOOL RD
Practice Address - Street 2:SUITE 5 FRANKLIN VILLAGE
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7646
Practice Address - Country:US
Practice Address - Phone:724-935-4300
Practice Address - Fax:724-935-4321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007821L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty