Provider Demographics
NPI:1154115632
Name:FAUST WELLNESS CHIROPRACTIC COMPANY
Entity type:Organization
Organization Name:FAUST WELLNESS CHIROPRACTIC COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BLAIR
Authorized Official - Middle Name:D
Authorized Official - Last Name:FAUST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-560-0585
Mailing Address - Street 1:575 MONTOUR BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-8509
Mailing Address - Country:US
Mailing Address - Phone:570-560-0585
Mailing Address - Fax:
Practice Address - Street 1:575 MONTOUR BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8509
Practice Address - Country:US
Practice Address - Phone:570-560-0585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty