Provider Demographics
NPI:1932522075
Name:BE WELL CHIROPRACTIC CENTER, CORP
Entity type:Organization
Organization Name:BE WELL CHIROPRACTIC CENTER, CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLYE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-691-4539
Mailing Address - Street 1:3715 BARDSTOWN RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-2244
Mailing Address - Country:US
Mailing Address - Phone:239-691-4539
Mailing Address - Fax:
Practice Address - Street 1:3715 BARDSTOWN RD
Practice Address - Street 2:SUITE 213
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-2244
Practice Address - Country:US
Practice Address - Phone:239-691-4539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY4769261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center