| Organization Name: | HEALTH AND WELLNESS CHIROPRACTIC CENTER, LLC |
| NPI Number: | 1255614715 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTHONY NHUT-THANH PHAM (OWNER) |
| Mailing Address: | 3851 River Rd N Keizer |
| State: | OR US |
| Postal Code: | 973034803 |
| Phone Number: | 5034636131 |
| Fax Number: | |
| NPI Enumeration Date: | 09/21/2011 |
| NPI Last Update Date: | 09/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 3737 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |