Provider Demographics
NPI:1891129367
Name:WISDOM WAVES CHIROPRACTIC CENTER, LLC
Entity type:Organization
Organization Name:WISDOM WAVES CHIROPRACTIC CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMI
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:340-201-6333
Mailing Address - Street 1:5316 YACHT HAVEN GRANDE
Mailing Address - Street 2:STE N 104 #114
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-5027
Mailing Address - Country:US
Mailing Address - Phone:340-201-6333
Mailing Address - Fax:
Practice Address - Street 1:#7&8 CURACAO GADE, KRONPRINDSENS QUARTER
Practice Address - Street 2:STE 205 &206
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-201-6333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-02
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty