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General NPI Number Information
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NPI Number | 1598645228
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Entity Type | Organization
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Legal Business Name | BODY & MIND WELLNESS CENTER
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 3700 OLD FOREST RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-6961
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Country | US
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Telephone | 570-540-6653
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Fax |
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Provider Business Mailing Address
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Address Line | 95 N PRINCETON CIR
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City | LYNCHBURG
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State | VA
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Zip | 24503-1554
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Country | US
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Telephone | 570-540-6653
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. DUMITRU ASANACHE
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Credential |
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Telephone | 570-540-6653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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