Provider Demographics
NPI:1346600640
Name:ANDREWS WELLNESS CENTER
Entity Type:Organization
Organization Name:ANDREWS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-520-7246
Mailing Address - Street 1:320A CHARLES H DIMMOCK PKWY STE 4&5
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2917
Mailing Address - Country:US
Mailing Address - Phone:804-520-7246
Mailing Address - Fax:
Practice Address - Street 1:320A CHARLES H DIMMOCK PKWY STE 4&5
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2917
Practice Address - Country:US
Practice Address - Phone:804-520-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1083089205OtherINDIVIDUAL NPI
VA1346600640OtherGROUP NPI