Provider Demographics
NPI:1508301425
Name:TOTAL WELLNESS PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:TOTAL WELLNESS PHYSICAL THERAPY PLLC
Other - Org Name:TOTAL WELLNESS PHYSICAL THERAPY PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:607-382-0132
Mailing Address - Street 1:6208 SYMONDS HILL RD
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:NY
Mailing Address - Zip Code:14801-9564
Mailing Address - Country:US
Mailing Address - Phone:607-382-0132
Mailing Address - Fax:
Practice Address - Street 1:48 MAIN ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:NY
Practice Address - Zip Code:14801-1210
Practice Address - Country:US
Practice Address - Phone:607-382-0132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-01
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027505261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy