Healthcare Provider Details
I. General information
NPI: 1295866200
Provider Name (Legal Business Name): TROXELL PHYSICAL THERAPY AND WELLNESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/08/2007
Last Update Date: 05/22/2024
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2351 W CLEVELAND AVE
MADERA CA
93637-8767
US
IV. Provider business mailing address
2351 W CLEVELAND AVE STE 101
MADERA CA
93637-8767
US
V. Phone/Fax
- Phone: 559-661-1611
- Fax: 559-661-1611
- Phone: 559-661-1611
- Fax: 559-661-1612
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 225200000X |
| License Number State | CA |
VIII. Authorized Official
Name:
HENRY
WAYNE
TROXELL
Title or Position: CO-OWNER/ PRESIDENT
Credential: DPT, OCS.
Phone: 559-661-1611