Provider Demographics
NPI:1487848826
Name:WELLNESS MANAGEMENT SERVICES LLC
Entity Type:Organization
Organization Name:WELLNESS MANAGEMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HEMPSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:207-576-7508
Mailing Address - Street 1:PO BOX 1120
Mailing Address - Street 2:
Mailing Address - City:SABATTUS
Mailing Address - State:ME
Mailing Address - Zip Code:04280-1120
Mailing Address - Country:US
Mailing Address - Phone:207-576-7508
Mailing Address - Fax:
Practice Address - Street 1:295 WATER ST
Practice Address - Street 2:SUITE 101
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-4621
Practice Address - Country:US
Practice Address - Phone:207-576-7508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1331261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy