Provider Demographics
NPI:1891927232
Name:SKELTON WELLNESS CENTER INC
Entity Type:Organization
Organization Name:SKELTON WELLNESS CENTER INC
Other - Org Name:SKELTON WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:SKELTON
Authorized Official - Suffix:
Authorized Official - Credentials:D,C,
Authorized Official - Phone:757-474-0842
Mailing Address - Street 1:1202 HARTFORD DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5844
Mailing Address - Country:US
Mailing Address - Phone:757-474-0842
Mailing Address - Fax:
Practice Address - Street 1:5762 CHESAPEAKE BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-5324
Practice Address - Country:US
Practice Address - Phone:757-853-2775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty