Provider Demographics
NPI:1710683248
Name:ORTHOPEDIC THERAPY AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:ORTHOPEDIC THERAPY AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-921-9000
Mailing Address - Street 1:2525 S RURAL RD STE 5S
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2444
Mailing Address - Country:US
Mailing Address - Phone:480-921-9000
Mailing Address - Fax:480-718-8160
Practice Address - Street 1:4302 E RAY RD STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4706
Practice Address - Country:US
Practice Address - Phone:480-597-4241
Practice Address - Fax:480-718-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty