Provider Demographics
NPI:1497293518
Name:ELMTREE WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:ELMTREE WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PASQUINI
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:570-390-7900
Mailing Address - Street 1:2489 ROUTE 6
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-6078
Mailing Address - Country:US
Mailing Address - Phone:570-390-7900
Mailing Address - Fax:570-390-7901
Practice Address - Street 1:2489 ROUTE 6
Practice Address - Street 2:SUITE 6
Practice Address - City:HAWLEY
Practice Address - State:PA
Practice Address - Zip Code:18428-6078
Practice Address - Country:US
Practice Address - Phone:570-390-7900
Practice Address - Fax:570-390-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA018579261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty