Organization
INNATE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY EJUWA (OWNER)
(715) 864-1657
Entity
Organization
Contact information
Practice address
5113 AUBURNDALE AVE, COLLEYVILLE, TX 76034-5197
(715) 864-1657
Mailing address
5113 AUBURNDALE AVE, COLLEYVILLE, TX 76034-5197
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
11959
TX
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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