Provider Demographics
NPI:1306559356
Name:ALPHA CHIROPRACTIC AND WELLNESS
Entity type:Organization
Organization Name:ALPHA CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:RINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL-JERLS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-343-0490
Mailing Address - Street 1:1288 KAPIOLANI BLVD APT 4306
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2876
Mailing Address - Country:US
Mailing Address - Phone:405-343-0490
Mailing Address - Fax:
Practice Address - Street 1:21 S PLAZA WAY
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5808
Practice Address - Country:US
Practice Address - Phone:405-343-0490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty