Provider Demographics
NPI:1588935449
Name:SUNRISE CHIROPRACTIC WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:SUNRISE CHIROPRACTIC WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:HELFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-846-8244
Mailing Address - Street 1:12651 W SUNRISE BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-0906
Mailing Address - Country:US
Mailing Address - Phone:954-846-8244
Mailing Address - Fax:954-846-9244
Practice Address - Street 1:12651 W SUNRISE BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-0906
Practice Address - Country:US
Practice Address - Phone:954-846-8244
Practice Address - Fax:954-846-9244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty