Provider Demographics
NPI:1972650828
Name:WASHINGTON WELLNESS CENTER PC
Entity Type:Organization
Organization Name:WASHINGTON WELLNESS CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SWANEKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-426-1700
Mailing Address - Street 1:1005 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3119
Mailing Address - Country:US
Mailing Address - Phone:609-426-1700
Mailing Address - Fax:609-426-0099
Practice Address - Street 1:1005 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-3119
Practice Address - Country:US
Practice Address - Phone:609-426-1700
Practice Address - Fax:609-426-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00334600111N00000X
NJ25MZ00027500171100000X
NJQA04979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty