Mountain State Wellness, Pllc

NPI #1023348448 in Morgantown, West Virginia

Provider Information

NPI Number: 1023348448
Entity Type: Organization
Organization Name: Mountain State Wellness, Pllc
Primary Specialty: Chiropractor
Enumeration Date: Jan 7, 2010
Last Updated: Jan 7, 2010

Practice Location

Address: 965 HARTMAN RUN RD
Address 2: SUITE 1101
City: Morgantown
State: West Virginia
ZIP Code: 26505-7700
Phone: (304) 292-7740

Authorized Official

Name: DR. LUCAS C WATTERSON, D.C.
Title: MEMBER/DIRECT OWNER
Phone: (304) 292-7740

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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