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General NPI Number Information
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NPI Number | 1760026629
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY WELLNESS, PLLC
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 201 DOLSON AVE STE H
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City | MIDDLETOWN
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State | NY
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Zip | 10940-6576
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Country | US
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Telephone | 845-343-0292
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Fax | 845-343-8759
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Provider Business Mailing Address
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Address Line | 201 DOLSON AVE STE H
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City | MIDDLETOWN
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State | NY
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Zip | 10940-6576
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Country | US
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Telephone | 845-343-0292
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Fax | 845-343-8759
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Authorized Official
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Title or Position | OWNER
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Name | ELEANORE ROBLES
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Credential | PT, DPT
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Telephone | 845-343-0292
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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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