Provider Demographics
NPI:1932521002
Name:BLUE SKY HEALTH AND WELLNESS
Entity type:Organization
Organization Name:BLUE SKY HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-975-9144
Mailing Address - Street 1:2826 NORBORNE PL
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-5001
Mailing Address - Country:US
Mailing Address - Phone:703-975-9144
Mailing Address - Fax:
Practice Address - Street 1:2944 HUNTER MILL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-1761
Practice Address - Country:US
Practice Address - Phone:703-975-9144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty