Provider Demographics
NPI:1356395511
Name:CHIROPRACTIC & WELLNESS CENTER, P.C.
Entity type:Organization
Organization Name:CHIROPRACTIC & WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRAJ
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-323-6858
Mailing Address - Street 1:1143 E. HIGH ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464
Mailing Address - Country:US
Mailing Address - Phone:610-323-6858
Mailing Address - Fax:610-323-6858
Practice Address - Street 1:1143 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-4953
Practice Address - Country:US
Practice Address - Phone:610-323-6858
Practice Address - Fax:610-323-6858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3965448OtherAETNA
PA2415995000OtherKEYSTONE HPE
PA1744698OtherHIGHMARK BS
PA2417343000OtherIBC
PA2417343000OtherIBC
PA3965448OtherAETNA