Provider Demographics
NPI:1861687204
Name:CHEVY CHASE WELLNESS CENTER L.L.C.
Entity Type:Organization
Organization Name:CHEVY CHASE WELLNESS CENTER L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CAI
Authorized Official - Suffix:
Authorized Official - Credentials:OMD LAC
Authorized Official - Phone:301-565-4673
Mailing Address - Street 1:2606 E WEST HWY
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3866
Mailing Address - Country:US
Mailing Address - Phone:301-565-4673
Mailing Address - Fax:
Practice Address - Street 1:2606 E WEST HWY
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3866
Practice Address - Country:US
Practice Address - Phone:301-565-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00898171100000X
MDU00806171100000X
VA0121000148171100000X
DCAC30015171100000X
DCAC30021171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty