Provider Demographics
NPI:1871283903
Name:WYNNE, LLC
Entity type:Organization
Organization Name:WYNNE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-312-2063
Mailing Address - Street 1:1 TOPSFIELD RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2131
Mailing Address - Country:US
Mailing Address - Phone:978-312-2063
Mailing Address - Fax:978-336-0344
Practice Address - Street 1:1 TOPSFIELD RD UNIT A
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-2131
Practice Address - Country:US
Practice Address - Phone:978-336-2063
Practice Address - Fax:978-336-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty