Provider Demographics
NPI:1902242290
Name:BRUCETON WELLNESS CENTER PLLC
Entity Type:Organization
Organization Name:BRUCETON WELLNESS CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:LINT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:304-379-7000
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:207 MORGANTOWN ST. SUITE 2
Mailing Address - City:BRUCETON MILLS
Mailing Address - State:WV
Mailing Address - Zip Code:26525-0129
Mailing Address - Country:US
Mailing Address - Phone:304-379-7000
Mailing Address - Fax:304-379-7010
Practice Address - Street 1:207 MORGANTOWN ST. SUITE 2
Practice Address - Street 2:
Practice Address - City:BRUCETON MILLS
Practice Address - State:WV
Practice Address - Zip Code:26525
Practice Address - Country:US
Practice Address - Phone:304-379-7000
Practice Address - Fax:304-379-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty