Organization
ACTIVE HEALTH AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA MEYERS (MANAGING PHYSICIAN)
(574) 259-9355
Entity
Organization
Contact information
Practice address
3027 MISHAWAKA AVE, SOUTH BEND, IN 46615-2347
(574) 259-9355
Mailing address
3027 MISHAWAKA AVE, SOUTH BEND, IN 46615-2347
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
51000262A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200253400
—
IN
Enumeration date
04/03/2007
Last updated
03/31/2010
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