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NPI Code Detail

MEDICARE: MIDLOTHIAN WELLNESS CLINIC, LLC

MEDICARE: MIDLOTHIAN WELLNESS CLINIC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QB0002XObesity Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1598141863
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDLOTHIAN WELLNESS CLINIC, LLC
Provider Business Mailing Address
First Line : 230 BROWNS WAY RD
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23114-9501
Country : US
Telephone Number : 804-419-9101
Fax Number :
Provider Business Practice Location Address
First Line : 230 BROWNS WAY RD
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23114-9501
Country : US
Telephone Number : 804-419-9101
Fax Number :
Authorized Official
Title or Position : COO
Name : CHRISTOPHER K CURRIN
Credential :
Telephone Number : 804-717-5000
Provider Enumeration Date : 08/10/2015
Last Update Date : 08/10/2015

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