Provider Demographics
NPI:1447469937
Name:AMERICAN WELLNESS CENTER
Entity type:Organization
Organization Name:AMERICAN WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BILODEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-943-9561
Mailing Address - Street 1:185 W MAIN ST
Mailing Address - Street 2:STE #1
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571
Mailing Address - Country:US
Mailing Address - Phone:508-943-9561
Mailing Address - Fax:508-943-4143
Practice Address - Street 1:185 W MAIN ST
Practice Address - Street 2:STE #1
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571
Practice Address - Country:US
Practice Address - Phone:508-943-9561
Practice Address - Fax:508-943-4143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA402111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y35291OtherBCBS MA
2752321OtherAETNA
MA1602152Medicaid
Y3721OtherHARVARD PILGRIM AA
1020501OtherFALLEN
847659200OtherCIGNA
97834301OtherNETWORK HEALTH
MAT58089Medicare UPIN
MAY45237Medicare UPIN