MEDICARE: PETITE PHYSIO AND WELLNESS LLC

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	:	1710769161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETITE PHYSIO AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	708 E FRANKLIN AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 E FRANKLIN AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4708
Country	:	US
Telephone Number	:	301-706-9218
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KATY CASTELL
Credential	:	DPT
Telephone Number	:	301-706-9218

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	10/19/2023

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Directions to “PETITE PHYSIO AND WELLNESS LLC ” Practice Location

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