MEDICARE: RESOLUTION WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1194091843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESOLUTION WELLNESS

Provider Business Mailing Address
First Line	:	1626 UNION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-4507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1626 UNION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-4507
Country	:	US
Telephone Number	:	415-732-9435
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RACHEL KILPATRICK
Credential	:
Telephone Number	:	770-640-1116

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	03/27/2012

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Directions to “RESOLUTION WELLNESS ” Practice Location

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