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Contact Information

MICHIANA WELLNESS AND LONGEVITY CLINIC, INC.
605 W EDISON RD
SUITE G
MISHAWAKA, IN46545-8823
 Phone: 574-258-4444
 Fax: 574-258-4445
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internist

111NI0900X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for MICHIANA WELLNESS AND LONGEVITY CLINIC INC · (Female)

NPI # 1306954466
Status Active
Credentials
Entity Individual
Enumeration date 08/29/2006
Last updated 03/30/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 08002006A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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