# WELLNESSMD @ ACAC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396932323
- **Authorized official:** PHIL G WENDEL (OWNER)
- **Authorized official phone:** (434) 974-9890

## Contact information

- **Practice address:** 406 ALBEMARLE SQ, CHARLOTTESVILLE, VA 22901-1472
- **Practice address phone:** (434) 817-4280
- **Practice address fax:** (434) 817-4281
- **Mailing address:** 406 ALBEMARLE SQUARE, CHARLOTTESVILLE, VA 22901-1472
- **Mailing address phone:** (434) 817-4280
- **Mailing address fax:** (434) 817-4281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | VA | Yes |

## Other

- **Enumeration date:** 10/03/2007
- **Last updated:** 04/22/2008