Organization
ESSENTIAL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN MCDONALD (CREDENTIALING)
(219) 769-1670
Entity
Organization
Contact information
Practice address
2309 45TH ST, HIGHLAND, IN 46322-2602
(219) 922-0202
Mailing address
2309 45TH ST, HIGHLAND, IN 46322-2602
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300029854
—
IN
Enumeration date
10/15/2020
Last updated
10/16/2020
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