Healthcare Provider Details

I. General information

NPI: 1659078491
Provider Name (Legal Business Name): THRIVE ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8346 TRAFORD LN STE B106
SPRINGFIELD VA
22152-1665
US

IV. Provider business mailing address

8346 TRAFORD LN STE B106
SPRINGFIELD VA
22152-1665
US

V. Phone/Fax

Practice location:
  • Phone: 703-563-2128
  • Fax:
Mailing address:
  • Phone: 703-563-2128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINA WELLNER
Title or Position: OWNER
Credential: DC
Phone: 757-416-4814