MEDICARE: RJ PHYSICAL THERAPY AND WELLNESS INC.

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	:	1447914684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RJ PHYSICAL THERAPY AND WELLNESS INC.

Provider Business Mailing Address
First Line	:	3756 W AVENUE 40 STE 2B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-3667
Country	:	US
Telephone Number	:	323-880-9938
Fax Number	:

Provider Business Practice Location Address
First Line	:	3756 W AVENUE 40 STE 2B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-3667
Country	:	US
Telephone Number	:	323-880-9938
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JENNY GADIA
Credential	:	PHYSICAL THERAPIST
Telephone Number	:	323-880-9938

Provider Enumeration Date	:	10/25/2021
Last Update Date	:	10/25/2021

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