MEDICARE: HEALTHWELL INC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1447325865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHWELL INC

Provider Business Mailing Address
First Line	:	1200 GOUGH ST
Second Line	:	SUITE 700
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6650
Country	:	US
Telephone Number	:	415-921-1211
Fax Number	:	415-921-1229

Provider Business Practice Location Address
First Line	:	1200 GOUGH ST
Second Line	:	SUITE 700
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-6650
Country	:	US
Telephone Number	:	415-921-1211
Fax Number	:	415-921-1229

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MS. ANN REVEL HICKS
Credential	:
Telephone Number	:	415-921-1211

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	12/09/2008

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Directions to “HEALTHWELL INC ” Practice Location

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