Provider Demographics
NPI:1659458321
Name:PIEDMONT HEALTH AND WELLNESS, PC
Entity Type:Organization
Organization Name:PIEDMONT HEALTH AND WELLNESS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:B
Authorized Official - Last Name:VON ELTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-656-2224
Mailing Address - Street 1:305 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:VA
Mailing Address - Zip Code:24557-4176
Mailing Address - Country:US
Mailing Address - Phone:434-656-2224
Mailing Address - Fax:
Practice Address - Street 1:305 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:VA
Practice Address - Zip Code:24557-4176
Practice Address - Country:US
Practice Address - Phone:434-656-2224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty