Provider Demographics
NPI:1609944792
Name:WELLNESS FIRST, INCORPORATED
Entity Type:Organization
Organization Name:WELLNESS FIRST, INCORPORATED
Other - Org Name:DONNELLY CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-897-3478
Mailing Address - Street 1:1660 ANDERSON HWY
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-8007
Mailing Address - Country:US
Mailing Address - Phone:804-897-3478
Mailing Address - Fax:
Practice Address - Street 1:1660 ANDERSON HWY
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-8007
Practice Address - Country:US
Practice Address - Phone:804-897-3478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC07011Medicare ID - Type Unspecified