Provider Demographics
NPI:1275134348
Name:EMPOWER HER PHYSICAL THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:EMPOWER HER PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KADISH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:304-654-2822
Mailing Address - Street 1:10857 GLENHURST ST
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8559
Mailing Address - Country:US
Mailing Address - Phone:304-654-2822
Mailing Address - Fax:
Practice Address - Street 1:10857 GLENHURST ST
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8559
Practice Address - Country:US
Practice Address - Phone:304-654-2822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy