Provider Demographics
NPI:1467625848
Name:ALL WELLNESS, LLC
Entity Type:Organization
Organization Name:ALL WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/ CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:CANNIZZARO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:802-863-9900
Mailing Address - Street 1:208 FLYNN AVE
Mailing Address - Street 2:STUDIO 3A
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5429
Mailing Address - Country:US
Mailing Address - Phone:802-863-9900
Mailing Address - Fax:802-863-9922
Practice Address - Street 1:208 FLYNN AVE
Practice Address - Street 2:STUDIO 3A
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-5429
Practice Address - Country:US
Practice Address - Phone:802-863-9900
Practice Address - Fax:802-863-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty