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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