Provider Demographics
NPI:1194461293
Name:EMPOWERED WELLNESSS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:EMPOWERED WELLNESSS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:256-652-7151
Mailing Address - Street 1:138 THOROUGHBRED LN
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8543
Mailing Address - Country:US
Mailing Address - Phone:256-652-7151
Mailing Address - Fax:
Practice Address - Street 1:138 THOROUGHBRED LN
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8543
Practice Address - Country:US
Practice Address - Phone:256-652-7151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health