Provider Demographics
NPI:1164079489
Name:WIL-POWERTHERAPY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:WIL-POWERTHERAPY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:352-322-6093
Mailing Address - Street 1:6843 N CITRUS AVE.
Mailing Address - Street 2:BLDG 2, UNIT T
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-6916
Mailing Address - Country:US
Mailing Address - Phone:352-322-6093
Mailing Address - Fax:352-794-3243
Practice Address - Street 1:6843 N CITRUS AVE UNIT T
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-6916
Practice Address - Country:US
Practice Address - Phone:352-322-6093
Practice Address - Fax:352-897-3206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty