Provider Demographics
NPI:1346306552
Name:PHYSICAL THERAPY AND WELLNESS CENTER--CORNING, INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY AND WELLNESS CENTER--CORNING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:530-824-9355
Mailing Address - Street 1:PO BOX 903
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:CA
Mailing Address - Zip Code:96021-0903
Mailing Address - Country:US
Mailing Address - Phone:530-824-9355
Mailing Address - Fax:530-824-5061
Practice Address - Street 1:710 SOLANO ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:CA
Practice Address - Zip Code:96021-3352
Practice Address - Country:US
Practice Address - Phone:530-824-9355
Practice Address - Fax:530-824-5061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty