Provider Demographics
NPI:1861196495
Name:OOLTEWAH REACH HEALTH AND WELLNESS PLLC
Entity type:Organization
Organization Name:OOLTEWAH REACH HEALTH AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-498-3400
Mailing Address - Street 1:5564 LITTLE DEBBIE PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:COLLEGE DALE
Mailing Address - State:TN
Mailing Address - Zip Code:37363-4333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5564 LITTLE DEBBIE PKWY STE 108
Practice Address - Street 2:
Practice Address - City:COLLEGE DALE
Practice Address - State:TN
Practice Address - Zip Code:37363-4333
Practice Address - Country:US
Practice Address - Phone:423-498-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty