Provider Demographics
NPI:1912416249
Name:BLUE APPLE WELLNESS, LLP
Entity Type:Organization
Organization Name:BLUE APPLE WELLNESS, LLP
Other - Org Name:BLUE APPLE WALK IN CHIROPRACTIC OF FARGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OOPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-600-5039
Mailing Address - Street 1:1008 N 7TH AVE STE I
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-2567
Mailing Address - Country:US
Mailing Address - Phone:406-404-1236
Mailing Address - Fax:
Practice Address - Street 1:1650 45TH ST S STE 113
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3247
Practice Address - Country:US
Practice Address - Phone:701-532-0397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty