Provider Demographics
NPI:1154697290
Name:WELLNESS SOULTIONS CENTER OF AUBURN
Entity type:Organization
Organization Name:WELLNESS SOULTIONS CENTER OF AUBURN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-832-3311
Mailing Address - Street 1:19 MIDSTATE DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-1858
Mailing Address - Country:US
Mailing Address - Phone:508-832-3311
Mailing Address - Fax:
Practice Address - Street 1:19 MIDSTATE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-1858
Practice Address - Country:US
Practice Address - Phone:508-832-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty