Provider Demographics
NPI:1164562302
Name:HEALTH AND WELLNESS GROUP, PLLC
Entity Type:Organization
Organization Name:HEALTH AND WELLNESS GROUP, PLLC
Other - Org Name:CAMPBELL CHIROPRACTIC HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-619-1002
Mailing Address - Street 1:2616 SHERWOOD HALL LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3100
Mailing Address - Country:US
Mailing Address - Phone:703-619-1002
Mailing Address - Fax:703-619-1340
Practice Address - Street 1:2616 SHERWOOD HALL LN
Practice Address - Street 2:SUITE 101
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306
Practice Address - Country:US
Practice Address - Phone:703-619-1002
Practice Address - Fax:703-619-1340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556180111N00000X
VA0104000759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF629OtherPIN NUMER CARE FIRST BCBS
VA183033OtherPIN NUMBER ANTHEM BCBS
VAF629OtherPIN NUMER CARE FIRST BCBS