MEDICARE: ORTHOPEDIC THERAPY AND WELLNESS, PLLC

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	2251X0800X	Orthopedic Physical Therapist

General Provider Information

NPI Number	:	1710683248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHOPEDIC THERAPY AND WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	2525 S RURAL RD STE 5S
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-2444
Country	:	US
Telephone Number	:	480-921-9000
Fax Number	:	480-718-8160

Provider Business Practice Location Address
First Line	:	4302 E RAY RD STE 105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-4706
Country	:	US
Telephone Number	:	480-597-4241
Fax Number	:	480-718-8160

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SHAWNA TUTELL
Credential	:
Telephone Number	:	480-921-9000

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	07/03/2024

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