Healthcare Provider Details

I. General information

NPI: 1588716765
Provider Name (Legal Business Name): WOMENS THERAPY AND WELLNESS COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 N SHADY LN
DOTHAN AL
36303-2946
US

IV. Provider business mailing address

407 N SHADY LN
DOTHAN AL
36303-2946
US

V. Phone/Fax

Practice location:
  • Phone: 334-673-7282
  • Fax: 334-673-7283
Mailing address:
  • Phone: 334-673-7282
  • Fax: 334-673-7283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier51503542
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBCBS PROVIDER NUMBER

VIII. Authorized Official

Name: MRS. MITZI TUTTLE
Title or Position: PTA OWNER
Credential: PTA
Phone: 334-673-7282