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General NPI Number Information
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NPI Number | 1740167881
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Entity Type | Organization
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Legal Business Name | WELLFORM PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 775 TARBORO RD STE 115
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City | YOUNGSVILLE
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State | NC
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Zip | 27596-9743
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Country | US
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Telephone | 919-880-0677
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Fax |
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Provider Business Mailing Address
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Address Line | 35 JAMES JOYCE CT
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City | YOUNGSVILLE
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State | NC
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Zip | 27596-8016
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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 | PHYSICAL THERAPIST/OWNER
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Name | ANNA MARIE SCHUMITTA
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Credential | PT, DPT
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Telephone | 919-810-7830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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