Provider Demographics
NPI:1912778416
Name:NEW JOURNEY CHIROPRACTOR AND WELLNESS LLC
Entity Type:Organization
Organization Name:NEW JOURNEY CHIROPRACTOR AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:WIEST
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DIBCN
Authorized Official - Phone:754-799-3852
Mailing Address - Street 1:5372 NE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1673
Mailing Address - Country:US
Mailing Address - Phone:786-503-9016
Mailing Address - Fax:
Practice Address - Street 1:1201 NE 26TH ST STE 106
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1206
Practice Address - Country:US
Practice Address - Phone:754-799-3852
Practice Address - Fax:754-799-3739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1871279547OtherNPPES