MEDICARE: INCLUSIVE PELVIC WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1104706605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INCLUSIVE PELVIC WELLNESS

Provider Business Mailing Address
First Line	:	46075 OCOTILLO DR APT 8
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-4672
Country	:	US
Telephone Number	:	443-375-1372
Fax Number	:	855-221-4318

Provider Business Practice Location Address
First Line	:	73550 ALESSANDRO DR STE 211
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-3613
Country	:	US
Telephone Number	:	443-375-1372
Fax Number	:	855-221-4318

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH MARIE HARE
Credential	:	DPT
Telephone Number	:	443-375-1372

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	09/04/2025

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Directions to “INCLUSIVE PELVIC WELLNESS ” Practice Location

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