Healthcare Provider Details
I. General information
NPI: 1942127311
Provider Name (Legal Business Name): TRUE WELLNESS PHYSICAL THERAPY AND PERFORMANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
535 EDWARDSVILLE RD STE 230
TROY IL
62294-1399
US
IV. Provider business mailing address
535 EDWARDSVILLE RD STE 230
TROY IL
62294-1399
US
V. Phone/Fax
- Phone: 636-345-2159
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
ERLER
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 636-345-2159