Provider Demographics
NPI:1154044592
Name:MCBRIDE WELLNESS CENTER LLC
Entity type:Organization
Organization Name:MCBRIDE WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-250-9612
Mailing Address - Street 1:127 N. GARDEN AVE.
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4119
Mailing Address - Country:US
Mailing Address - Phone:727-977-9005
Mailing Address - Fax:727-499-2798
Practice Address - Street 1:127 N. GARDEN AVE.
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-4119
Practice Address - Country:US
Practice Address - Phone:727-977-9005
Practice Address - Fax:727-499-2798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty