Provider Demographics
NPI:1639628233
Name:RESOLUTION WELLNESS
Entity Type:Organization
Organization Name:RESOLUTION WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KILPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-691-7315
Mailing Address - Street 1:67 HOLLY HILL LN
Mailing Address - Street 2:LOCATED INSIDE PEAK 360
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6072
Mailing Address - Country:US
Mailing Address - Phone:203-625-9595
Mailing Address - Fax:866-813-0930
Practice Address - Street 1:67 HOLLY HILL LN
Practice Address - Street 2:LOCATED INSIDE PEAK 360
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6072
Practice Address - Country:US
Practice Address - Phone:203-625-9595
Practice Address - Fax:866-813-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-25
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT111632251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty