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General NPI Number Information
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NPI Number | 1467033068
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Entity Type | Organization
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Legal Business Name | BODYWELL PHYSICAL THERAPY AND WELLNESS, INC.
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Dates
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Enumeration Date | 04/16/2021
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 19724 KITTRIDGE ST
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City | WINNETKA
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State | CA
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Zip | 91306-4327
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Country | US
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Telephone | 818-424-2413
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Fax |
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Provider Business Mailing Address
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Address Line | 19724 KITTRIDGE ST
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City | WINNETKA
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State | CA
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Zip | 91306-4327
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | KEREN PINTO
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Credential | DPT
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Telephone | 818-424-2413
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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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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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