Provider Demographics
NPI:1982896353
Name:C3, INC
Entity Type:Organization
Organization Name:C3, INC
Other - Org Name:VITAL WELLNESS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:PIERRE
Authorized Official - Last Name:CHARTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-277-9355
Mailing Address - Street 1:2601 APACHE CT
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-1504
Mailing Address - Country:US
Mailing Address - Phone:712-277-9355
Mailing Address - Fax:712-277-9366
Practice Address - Street 1:2601 APACHE CT
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-1504
Practice Address - Country:US
Practice Address - Phone:712-277-9355
Practice Address - Fax:712-277-9366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06891111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1982896353OtherGROUP NPI 1982896353
IA1316955594OtherNPI SEAN E. CHARTIER D.C.
IA0497446Medicaid
IAI21041OtherGROUP PTAN
IAI21041OtherGROUP PTAN
IA1982896353OtherGROUP NPI 1982896353