Provider Demographics
NPI:1902284763
Name:REDLANDS CHIROPRACTIC & WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:REDLANDS CHIROPRACTIC & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-243-5164
Mailing Address - Street 1:2148 BROADWAY STE C3
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81507-1098
Mailing Address - Country:US
Mailing Address - Phone:970-243-5164
Mailing Address - Fax:970-243-0945
Practice Address - Street 1:2148 BROADWAY STE C3
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81507-1098
Practice Address - Country:US
Practice Address - Phone:970-243-5164
Practice Address - Fax:970-243-0945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6170111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty