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Organization
CENTRAL FLORIDA INTEGRATED WELLNESS CLINIC PLLC
Active
Organization
CENTRAL FLORIDA INTEGRATED WELLNESS CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANNING C. BOLICK D.C. (MGR)
(407) 629-5333
Entity
Organization
Contact information
Practice address
500 E HORATIO AVE, SUITE 5, MAITLAND, FL 32751-7310
(407) 629-5333
(407) 629-5343
Mailing address
500 E HORATIO AVE, SUITE 5, MAITLAND, FL 32751-7310
(407) 629-5333
(407) 629-5343
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH7882
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME45785
FL
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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