Provider Demographics
NPI:1316455009
Name:WELCOME HOME FAMILY CHIROPRACTIC & WELLNESS CENTER, PLLC
Entity type:Organization
Organization Name:WELCOME HOME FAMILY CHIROPRACTIC & WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOUBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESULME
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-317-5738
Mailing Address - Street 1:3773 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8338
Mailing Address - Country:US
Mailing Address - Phone:727-317-5738
Mailing Address - Fax:
Practice Address - Street 1:3773 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8338
Practice Address - Country:US
Practice Address - Phone:727-317-5738
Practice Address - Fax:214-206-9930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty