Provider Demographics
NPI:1437617974
Name:LIVE WELL PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:LIVE WELL PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:GRIEGEL
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:610-659-1921
Mailing Address - Street 1:114 SYLVAN DR
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-8325
Mailing Address - Country:US
Mailing Address - Phone:610-659-1921
Mailing Address - Fax:
Practice Address - Street 1:114 SYLVAN DR
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-8325
Practice Address - Country:US
Practice Address - Phone:610-659-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty