Healthcare Provider Details

I. General information

NPI: 1528750288
Provider Name (Legal Business Name): THERAPEUTIC WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 BENTON LN
DENHAM SPRINGS LA
70726-4516
US

IV. Provider business mailing address

7265 JEANE LN
DENHAM SPRINGS LA
70706-1973
US

V. Phone/Fax

Practice location:
  • Phone: 225-235-3953
  • Fax:
Mailing address:
  • Phone: 225-235-3953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. CHERYL JEANE
Title or Position: OWNER, PT
Credential: PT, DPT
Phone: 225-235-3953