Provider Demographics
NPI:1487727822
Name:TRANQUILITY WELLNESS CENTER
Entity type:Organization
Organization Name:TRANQUILITY WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDREMCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:209-634-2225
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95381-0012
Mailing Address - Country:US
Mailing Address - Phone:209-634-2225
Mailing Address - Fax:209-668-6846
Practice Address - Street 1:2330 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2013
Practice Address - Country:US
Practice Address - Phone:209-634-2225
Practice Address - Fax:209-668-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty