Provider Demographics
NPI:1437911260
Name:FROM THE GROUND UP PHYSICAL THERAPY & WELLNESS LLC
Entity Type:Organization
Organization Name:FROM THE GROUND UP PHYSICAL THERAPY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROARTY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:816-323-0992
Mailing Address - Street 1:2202 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64501-3121
Mailing Address - Country:US
Mailing Address - Phone:816-323-0992
Mailing Address - Fax:
Practice Address - Street 1:2202 LOCUST ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64501-3121
Practice Address - Country:US
Practice Address - Phone:816-323-0992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty