Provider Demographics
NPI:1578248555
Name:EMPOWER WELLNESS AND PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:EMPOWER WELLNESS AND PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RAWLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-205-1048
Mailing Address - Street 1:2692 KIMBERLY FOREST DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-9575
Mailing Address - Country:US
Mailing Address - Phone:386-205-1048
Mailing Address - Fax:
Practice Address - Street 1:2692 KIMBERLY FOREST DR E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-9575
Practice Address - Country:US
Practice Address - Phone:386-205-1048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty