Provider Demographics
NPI:1619148251
Name:E & R HEALTH AND WELLNESS INC
Entity Type:Organization
Organization Name:E & R HEALTH AND WELLNESS INC
Other - Org Name:PHYSICAL THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUGGIERO
Authorized Official - Middle Name:S
Authorized Official - Last Name:CANIZARES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:541-345-7532
Mailing Address - Street 1:1310 COBURG ROAD #5
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-345-7532
Mailing Address - Fax:541-345-6692
Practice Address - Street 1:1310 COBURG ROAD #5
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-345-7532
Practice Address - Fax:541-345-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2241225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR024363Medicaid
ORDN3899OtherRRMC
OR024363Medicaid