MEDICARE: THERAPEUTIC WELLNESS, LLC

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	:	1528750288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC WELLNESS, LLC

Provider Business Mailing Address
First Line	:	7265 JEANE LN
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70706-1973
Country	:	US
Telephone Number	:	225-235-3953
Fax Number	:

Provider Business Practice Location Address
First Line	:	1680 BENTON LN
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-4516
Country	:	US
Telephone Number	:	225-235-3953
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PT
Name	:	MRS. CHERYL JEANE
Credential	:	PT, DPT
Telephone Number	:	225-235-3953

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	05/22/2023

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Directions to “THERAPEUTIC WELLNESS, LLC ” Practice Location

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