Provider Demographics
NPI:1902518111
Name:WELLNESS WITH DR. SHARON, LLC
Entity Type:Organization
Organization Name:WELLNESS WITH DR. SHARON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-262-4858
Mailing Address - Street 1:41 S OLD ORCHARD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3202
Mailing Address - Country:US
Mailing Address - Phone:314-262-4858
Mailing Address - Fax:314-262-4073
Practice Address - Street 1:41 S OLD ORCHARD AVE STE B
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-3202
Practice Address - Country:US
Practice Address - Phone:314-262-4858
Practice Address - Fax:314-262-4073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1154668028OtherNPI