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Organization

WELLNESS OF SD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VINCENTE T ORTIZ JR. (OWNER)
(805) 727-1234
Entity
Organization

Contact information

Practice address
5350 RILEY ST, SAN DIEGO, CA 92110-2621
(805) 727-1234
Mailing address
4150 ALBATROSS DR, SAN DIEGO, CA 92103-1905
(805) 727-1234

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary

Other

Enumeration date
06/29/2022
Last updated
07/22/2022
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