Healthcare Provider Details

I. General information

NPI: 1063078392
Provider Name (Legal Business Name): WELL BEINGS THERAPIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 MAIN ST STE 6
WENHAM MA
01984-1459
US

IV. Provider business mailing address

225 MAIN ST STE 6
WENHAM MA
01984-1459
US

V. Phone/Fax

Practice location:
  • Phone: 978-468-6300
  • Fax: 978-468-6300
Mailing address:
  • Phone: 978-468-6300
  • Fax: 978-468-6300

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
Identifier1013373828
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerNPPES
# 2
Identifier1255324570
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerNPPES

VIII. Authorized Official

Name: MARIKA P CONWAY
Title or Position: CO-OWNER, ATHLETIC TRAINER
Credential: ATC
Phone: 978-430-0316