Provider Demographics
NPI:1912591421
Name:LC WELLNESS LLC
Entity Type:Organization
Organization Name:LC WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHISCHILLY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:480-297-3462
Mailing Address - Street 1:4727 N HOBBY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67219-3013
Mailing Address - Country:US
Mailing Address - Phone:480-297-3462
Mailing Address - Fax:
Practice Address - Street 1:200 N BROADWAY AVE STE 220
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-2328
Practice Address - Country:US
Practice Address - Phone:316-247-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty