Healthcare Provider Details

I. General information

NPI: 1265267694
Provider Name (Legal Business Name): RXWELLNESS SPINE & HEALTH - ALDIE SOUTH RIDING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24600 MILLSTREAM DR STE 360
ALDIE VA
20105-5686
US

IV. Provider business mailing address

24600 MILLSTREAM DR STE 360
ALDIE VA
20105-5686
US

V. Phone/Fax

Practice location:
  • Phone: 703-904-9666
  • Fax:
Mailing address:
  • Phone: 703-904-9666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILIP GOLINSKY
Title or Position: OWNER
Credential: DC
Phone: 703-904-9666