Organization
PRIME WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABUBAKARI WELLE M.D (PROPRIETOR)
(703) 598-6146
Entity
Organization
Contact information
Practice address
14904 JEFFERSON DAVIS HWY, SUITE 305, WOODBRIDGE, VA 22191-3908
(571) 492-7702
(571) 492-7704
Mailing address
14904 JEFFERSON DAVIS HWY, SUITE 305, WOODBRIDGE, VA 22191-3908
(571) 492-7702
(571) 492-7704
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101245731
VA
Other
Enumeration date
02/25/2013
Last updated
09/14/2017
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