MEDICARE: INCLUSIVE PELVIC WELLNESS PHYSIOTHERAPY PC

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	:	1699649897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INCLUSIVE PELVIC WELLNESS PHYSIOTHERAPY PC

Provider Business Mailing Address
First Line	:	46075 OCOTILLO DR APT 8
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-4672
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	73550 ALESSANDRO DR STE 11
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-3613
Country	:	US
Telephone Number	:	443-375-1372
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SARAH HARE
Credential	:	PT
Telephone Number	:	443-375-1372

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	11/03/2025

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