Provider Demographics
NPI:1629898903
Name:JCR INTEGRATIVE WELLNESS
Entity type:Organization
Organization Name:JCR INTEGRATIVE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MASSAGE THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DAC,LMT
Authorized Official - Phone:570-702-5181
Mailing Address - Street 1:439 NEW MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6424
Mailing Address - Country:US
Mailing Address - Phone:570-702-5181
Mailing Address - Fax:
Practice Address - Street 1:73 MONTAGE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MOOSIC
Practice Address - State:PA
Practice Address - Zip Code:18507-1751
Practice Address - Country:US
Practice Address - Phone:570-702-5181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service