Provider Demographics
NPI:1790917540
Name:ACCIDENT, INJURY & PAIN WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:ACCIDENT, INJURY & PAIN WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:O'QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-373-1303
Mailing Address - Street 1:1965 JEFFERSON DAVIS HWY
Mailing Address - Street 2:SUITE 200B
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-6213
Mailing Address - Country:US
Mailing Address - Phone:540-373-1303
Mailing Address - Fax:540-373-6061
Practice Address - Street 1:1965 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 200B
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-6213
Practice Address - Country:US
Practice Address - Phone:540-373-1303
Practice Address - Fax:540-373-6061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty