| Organization Name: | JWCM, LLC |
| NPI Number: | 1235393596 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIE KRISTINE WALTRIP (PRESIDENT/DENTIST) |
| Mailing Address: | 30875 Interstate 10 W Suite B Boerne |
| State: | TX US |
| Postal Code: | 780069252 |
| Phone Number: | 8307556475 |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2008 |
| NPI Last Update Date: | 07/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 19842 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |