Provider Demographics
NPI:1902647787
Name:IRON MOUNTAIN WELLNESS WAY LLC
Entity type:Organization
Organization Name:IRON MOUNTAIN WELLNESS WAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-828-1384
Mailing Address - Street 1:601 S WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49802-1111
Mailing Address - Country:US
Mailing Address - Phone:906-828-1384
Mailing Address - Fax:
Practice Address - Street 1:601 S WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:KINGSFORD
Practice Address - State:MI
Practice Address - Zip Code:49802-1111
Practice Address - Country:US
Practice Address - Phone:906-828-1384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty