Provider Demographics
NPI:1194996454
Name:WELLNESSONE OF WESTFIELD, INC.
Entity type:Organization
Organization Name:WELLNESSONE OF WESTFIELD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:HENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-440-7411
Mailing Address - Street 1:6800 S 32ND ST STE A
Mailing Address - Street 2:STE. 201
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6036
Mailing Address - Country:US
Mailing Address - Phone:402-325-0170
Mailing Address - Fax:402-325-0173
Practice Address - Street 1:630 N COTNER BLVD
Practice Address - Street 2:STE. 201
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2339
Practice Address - Country:US
Practice Address - Phone:402-325-0170
Practice Address - Fax:402-325-0173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty