Organization
MOUNTAINEER CHIROPRACTIC, P.L.L.C.
Active
Other names
Mountaineer Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN BOLES WELLS D.C. (MANAGER / OWNER)
(304) 422-9600
Entity
Organization
Contact information
Practice address
2108 CAMDEN AVE, SUITE D, PARKERSBURG, WV 26101-5672
(304) 422-9600
(304) 422-9603
Mailing address
2108 CAMDEN AVE, SUITE D, PARKERSBURG, WV 26101-5672
(304) 422-9600
(304) 422-9603
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
664
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001710889
MSBCBS
—
05
—
0132314000
—
WV
Enumeration date
05/23/2007
Last updated
08/08/2016
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