Provider Demographics
NPI:1659478964
Name:BELL CREEK CHIROPRACTIC & WELLNESS CENTER, INC
Entity Type:Organization
Organization Name:BELL CREEK CHIROPRACTIC & WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:BS DC
Authorized Official - Phone:804-616-4515
Mailing Address - Street 1:7481 RIGHT FLANK RD
Mailing Address - Street 2:100
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-3838
Mailing Address - Country:US
Mailing Address - Phone:804-616-4515
Mailing Address - Fax:804-616-4516
Practice Address - Street 1:7481 RIGHT FLANK RD
Practice Address - Street 2:100
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3838
Practice Address - Country:US
Practice Address - Phone:804-616-4515
Practice Address - Fax:804-616-4516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU70469Medicare UPIN