Provider Demographics
NPI:1649451451
Name:GLOBAL WELLNESS CLINIC, P.C.
Entity type:Organization
Organization Name:GLOBAL WELLNESS CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-795-3655
Mailing Address - Street 1:2378 S AVE
Mailing Address - Street 2:
Mailing Address - City:MADRID
Mailing Address - State:IA
Mailing Address - Zip Code:50156-7593
Mailing Address - Country:US
Mailing Address - Phone:515-795-3655
Mailing Address - Fax:515-795-3656
Practice Address - Street 1:2378 S AVE
Practice Address - Street 2:
Practice Address - City:MADRID
Practice Address - State:IA
Practice Address - Zip Code:50156-7593
Practice Address - Country:US
Practice Address - Phone:515-795-3655
Practice Address - Fax:515-795-3656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0431379Medicaid
IA0431379Medicaid