Provider Demographics
NPI:1992137434
Name:GARDEN CHIROPRACTIC AND WELLNESS CENTER,LLC
Entity type:Organization
Organization Name:GARDEN CHIROPRACTIC AND WELLNESS CENTER,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-276-7896
Mailing Address - Street 1:314 E PLANT ST
Mailing Address - Street 2:A-103
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3133
Mailing Address - Country:US
Mailing Address - Phone:407-276-7896
Mailing Address - Fax:407-287-5196
Practice Address - Street 1:314 E PLANT ST
Practice Address - Street 2:A-103
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3133
Practice Address - Country:US
Practice Address - Phone:407-276-7896
Practice Address - Fax:407-287-5196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty