MEDICARE: ENRICH PHYSICAL THERAPY AND 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1528857521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENRICH PHYSICAL THERAPY AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	26003 PARTY SLIPPERS DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78255-3436
Country	:	US
Telephone Number	:	814-431-9949
Fax Number	:

Provider Business Practice Location Address
First Line	:	9542 WITTEN DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-2179
Country	:	US
Telephone Number	:	989-600-4142
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS PARTNER
Name	:	SURYANARAYANA RAJU KALIDINDI
Credential	:
Telephone Number	:	814-431-9949

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	05/05/2025

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Directions to “ENRICH PHYSICAL THERAPY AND WELLNESS LLC ” Practice Location

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