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Organization
WELLNESSONE OF EAST BELLEVILLE, LLC
Active
Organization
WELLNESSONE OF EAST BELLEVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT M DORRITY D.C. (MANAGING EMPLOYEE)
(618) 398-9716
Entity
Organization
Contact information
Practice address
1634 CARLYLE AVE, BELLEVILLE, IL 62221-4558
(618) 235-0777
(618) 235-9440
Mailing address
1634 CARLYLE AVE, BELLEVILLE, IL 62221-4558
(618) 235-0777
(618) 235-9440
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
225100000X
Physical Therapist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08212176
BCBS GROUP NUMBER
IL
Enumeration date
04/23/2007
Last updated
10/11/2007
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