Provider Demographics
NPI:1750912499
Name:WELLFIT CHIROPRACTIC LLC
Entity type:Organization
Organization Name:WELLFIT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:WISSBROECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-413-8300
Mailing Address - Street 1:685 W BRIDGE ST STE 7
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-2888
Mailing Address - Country:US
Mailing Address - Phone:507-413-8300
Mailing Address - Fax:
Practice Address - Street 1:685 W BRIDGE ST STE 7
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-2888
Practice Address - Country:US
Practice Address - Phone:507-413-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty