Healthcare Provider Details

I. General information

NPI: 1861322067
Provider Name (Legal Business Name): THE PELVIC NOOK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18323 PARKSVILLE DR
ESTERO FL
33928-9673
US

IV. Provider business mailing address

18323 PARKSVILLE DR
ESTERO FL
33928-9673
US

V. Phone/Fax

Practice location:
  • Phone: 518-894-4505
  • Fax:
Mailing address:
  • Phone: 518-894-4505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KAYLEE FIEDLER
Title or Position: OWNER
Credential: DPT, PT, PRPC
Phone: 518-894-4505