Healthcare Provider Details

I. General information

NPI: 1558289439
Provider Name (Legal Business Name): CASTLE AQUATIC THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 S CAMPBELL AVE
SPRINGFIELD MO
65810-2408
US

IV. Provider business mailing address

8313 SHINNECOCK DR
NIXA MO
65714-7372
US

V. Phone/Fax

Practice location:
  • Phone: 417-883-5151
  • Fax:
Mailing address:
  • Phone: 561-531-2056
  • 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. BETHANY ASTLE
Title or Position: OWNER
Credential: PTA
Phone: 561-531-2056