Organization
FUNCTIONAL WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW LEE KELLOGG D.C. (OWNER)
(517) 499-8791
Entity
Organization
Contact information
Practice address
7555 E OSBORN RD, STE. 102, SCOTTSDALE, AZ 85251-6434
(517) 499-8791
Mailing address
7555 E OSBORN RD, STE. 102, SCOTTSDALE, AZ 85251-6434
(517) 499-8791
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
8489
AZ
111N00000X
Chiropractor
Primary
8490
AZ
Other
Enumeration date
07/22/2015
Last updated
10/15/2015
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