MEDICARE: ONWARD WELLNESS AND REHAB 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	:	1689283392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONWARD WELLNESS AND REHAB LLC

Provider Business Mailing Address
First Line	:	2216 TEAKWOOD AVE NW
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97304-1344
Country	:	US
Telephone Number	:	503-684-0311
Fax Number	:	503-689-8088

Provider Business Practice Location Address
First Line	:	2216 TEAKWOOD AVE NW
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97304-1344
Country	:	US
Telephone Number	:	503-684-0311
Fax Number	:	503-689-8088

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	CARY EDGAR
Credential	:
Telephone Number	:	480-206-6240

Provider Enumeration Date	:	07/28/2020
Last Update Date	:	07/28/2020

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Directions to “ONWARD WELLNESS AND REHAB LLC ” Practice Location

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