Provider Demographics
NPI:1568573301
Name:WELLNESS AND THERAPY SOLUTIONS
Entity Type:Organization
Organization Name:WELLNESS AND THERAPY SOLUTIONS
Other - Org Name:GUNTER PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:MARLIN
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:903-433-1401
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:GUNTER
Mailing Address - State:TX
Mailing Address - Zip Code:75058-0247
Mailing Address - Country:US
Mailing Address - Phone:903-433-1401
Mailing Address - Fax:903-433-1398
Practice Address - Street 1:610 N 8TH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:GUNTER
Practice Address - State:TX
Practice Address - Zip Code:75058-3586
Practice Address - Country:US
Practice Address - Phone:903-433-1401
Practice Address - Fax:903-433-1398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1132587261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0067NUOtherBCBS OF TEXAS
TX0067NUOtherBCBS OF TEXAS