| Olde Towne Wellness Llc | |
| 515 S Sycamore St, Petersburg, VA 23803-5037 | |
| (804) 733-8377 | |
| (804) 733-8459 | 
| Full Name | Olde Towne Wellness Llc | 
|---|---|
| Type | Facility | 
| Speciality | Chiropractor | 
| Location | 515 S Sycamore St, Petersburg, Virginia | 
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144388315 | NPI | - | NPPES | 
| 418235 | Other | VA | SOUTHERN HEALTH | 
| 191798 | Other | VA | ANTHEM | 
| 640-504 | Other | VA | UNITED HEATH CARE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 111N00000X | Chiropractor | 0104001801 (Virginia) | Primary | 
| Provider Name | Thomas J Hennessey | 
|---|---|
| Provider Type | Practitioner - Chiropractic | 
| Provider Identifiers | NPI Number: 1285792424 PECOS PAC ID: 4183606023 Enrollment ID: I20040603001040 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Olde Towne Wellness Llc 515 S Sycamore St, Petersburg, VA 23803-5037 Ph: (804) 733-8377 | Olde Towne Wellness Llc 515 S Sycamore St, Petersburg, VA 23803-5037 Ph: (804) 733-8377 | 
| Dr. Thomas James Hennessey, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 515 S Sycamore St, Petersburg, VA 23803 Phone: 804-733-8377 Fax: 804-733-8459 | |
| Chiro One Wellness Center Of Petersburg Llc Chiropractor Medicare: Medicare Enrolled Practice Location: 34 Medical Park Blvd Ste C, Petersburg, VA 23805 Phone: 804-862-2255 | |
| Dr. Paul Eric Tschetschot, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 34 Medical Park Blvd, Suite C, Petersburg, VA 23805 Phone: 804-862-2255 Fax: 804-862-1004 | |
| Dr. Shawn Edward Harper, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 320 S Sycamore St, Petersburg, VA 23803 Phone: 571-265-9323 | |
| Commonwealth Alliance Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 34 Medical Park Blvd Ste C, Petersburg, VA 23805 Phone: 804-862-2255 Fax: 804-862-1004 |