Provider Demographics
NPI:1902909880
Name:SPAIN WELLNESS CENTER INC
Entity type:Organization
Organization Name:SPAIN WELLNESS CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNATHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEWLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-433-1111
Mailing Address - Street 1:1117 N PALAFOX ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-2607
Mailing Address - Country:US
Mailing Address - Phone:850-433-1111
Mailing Address - Fax:850-434-6995
Practice Address - Street 1:1117 N PALAFOX ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2607
Practice Address - Country:US
Practice Address - Phone:850-433-1111
Practice Address - Fax:850-434-6995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty