| Organization Name: | THE WELLNESS CLINIC INC. |
| NPI Number: | 1124456330 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON KOENIGS (PRESIDENT AND CFO) |
| Mailing Address: | 1281 Marinette Ave Marinette |
| State: | WI US |
| Postal Code: | 541432018 |
| Phone Number: | 7157355500 |
| Fax Number: | 7157355502 |
| NPI Enumeration Date: | 10/24/2013 |
| NPI Last Update Date: | 04/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |