Provider Demographics
NPI:1821824079
Name:WILLOW WELLNESS CENTER
Entity type:Organization
Organization Name:WILLOW WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-706-9500
Mailing Address - Street 1:2101 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301-1359
Mailing Address - Country:US
Mailing Address - Phone:703-706-9500
Mailing Address - Fax:
Practice Address - Street 1:2101 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22301-1359
Practice Address - Country:US
Practice Address - Phone:703-706-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty