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Organization
WELLNESS WORX CENTER PLLC
Active
Organization
WELLNESS WORX CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLEN CHARLES PETTERSEN DC (OWNER)
(727) 474-9729
Entity
Organization
Contact information
Practice address
2495 ENTERPRISE RD, STE104, CLEARWATER, FL 33763-1795
(727) 474-9729
(727) 474-9947
Mailing address
2495 ENTERPRISE RD, STE104, CLEARWATER, FL 33763-1795
(727) 474-9729
(727) 474-9947
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH8772
FL
111N00000X
Chiropractor
Primary
CH8923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1038157
AMERICAN SPECIALTY HEALTH
FL
01
—
1147626
FIRST HEALTH
FL
01
—
1538210
AETNA
FL
01
—
656080
UNITED HEALTH CARE
FL
01
—
71494
BLUE CROSS BLUE SHIELD OF FL
FL
01
—
9067913
CIGNA
FL
Enumeration date
04/15/2010
Last updated
04/15/2010
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