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Organization
DIVINE MEDICAL WELLNESS CENTER INC
Active
Organization
DIVINE MEDICAL WELLNESS CENTER INC
Active
Other names
Divine Medical Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL LYNN ROULUND DC (PRESIDENT)
(559) 222-5362
Entity
Organization
Contact information
Practice address
5150 N 6TH ST STE 100, FRESNO, CA 93710-7505
(559) 222-5362
Mailing address
5150 N 6TH ST STE 100, FRESNO, CA 93710-7505
(559) 222-5362
(559) 222-5028
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/26/2014
Last updated
03/26/2014
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