Provider Demographics
NPI:1427748995
Name:DIVINE HEALTH AND WELLNESS CORP
Entity type:Organization
Organization Name:DIVINE HEALTH AND WELLNESS CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:DEVINE
Authorized Official - Last Name:SALVI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:301-980-4301
Mailing Address - Street 1:220 GEESE LNDG
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-5875
Mailing Address - Country:US
Mailing Address - Phone:301-980-4301
Mailing Address - Fax:
Practice Address - Street 1:11412 BELVEDERE VISTA LN
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4392
Practice Address - Country:US
Practice Address - Phone:301-980-4301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty