Innate Wellness Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

11959 Issued in TX

Legal business name

INNATE WELLNESS CENTER

Practice address

5113 Auburndale Ave
Colleyville, TX 76034-5197

Phone

(715) 864-1657

NPI assigned

Feb 7, 2012

Last updated

Feb 7, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jerry Ejuwa

Title

Owner

Phone

(715) 864-1657

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1033481064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 AUBURNDALE AVE",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 AUBURNDALE AVE",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760345197",
            "telephone_number": "715-864-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNATE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "EJUWA",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-864-1657",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.