MEDICARE: WHOLISTIC MOTUS 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	PT29036	FL

General Provider Information

NPI Number	:	1760905806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLISTIC MOTUS LLC

Provider Business Mailing Address
First Line	:	2059 ALTAMONT AVE STE 105
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3281
Country	:	US
Telephone Number	:	239-400-5639
Fax Number	:	866-835-2456

Provider Business Practice Location Address
First Line	:	2059 ALTAMONT AVE STE 105
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3281
Country	:	US
Telephone Number	:	239-400-5639
Fax Number	:	866-835-2456

Authorized Official
Title or Position	:	OWNER, DOCTOR OF PHYSICAL THERAPY
Name	:	DR. JODY PAITRA MOHLE CORR
Credential	:	PT DPT
Telephone Number	:	239-400-5639

Provider Enumeration Date	:	07/20/2017
Last Update Date	:	02/06/2026

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