Provider Demographics
NPI:1093491094
Name:EMPOWERED CARE PHYSICAL THERAPY AND WOUND CARE PLLC
Entity Type:Organization
Organization Name:EMPOWERED CARE PHYSICAL THERAPY AND WOUND CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:LUND
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CWS
Authorized Official - Phone:801-505-3886
Mailing Address - Street 1:7921 MIDNIGHT RIDE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-1966
Mailing Address - Country:US
Mailing Address - Phone:801-505-3886
Mailing Address - Fax:
Practice Address - Street 1:7921 MIDNIGHT RIDE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-1966
Practice Address - Country:US
Practice Address - Phone:801-505-3886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty