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NPI 1275321556

NPI 1275321556 : JEWEL PHYSICAL THERAPY AND WELLNESS, INC : LA MESA, CA

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General NPI Number Information
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    NPI Number           |    1275321556
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    Entity Type          |    Organization 
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    Legal Business Name  |    JEWEL PHYSICAL THERAPY AND WELLNESS, INC 
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Dates
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    Enumeration Date     |    04/28/2025
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    Last Update Date     |    04/28/2025
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Provider Practice Location Address
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    Address Line         |    4960 ROSEHEDGE DR 
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    City                 |    LA MESA
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    State                |    CA
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    Zip                  |    91942-9519
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    Country              |    US
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    Telephone            |    980-785-3935
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4960 ROSEHEDGE DR 
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    City                 |    LA MESA
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    State                |    CA
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    Zip                  |    91942-9519
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    Country              |    US
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    Telephone            |    980-785-3935
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     KRISTEN KNIGHTLY CAMPBELL 
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    Credential           |    PT, DPT
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    Telephone            |    413-281-4305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QP2000X
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    Taxonomy Name        |    Physical Therapy Clinic/Center
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    License Number       |    
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    License Number State |    
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