Provider Demographics
NPI:1760156848
Name:TENSEGRITY PHYSICAL THERAPY AND WELLNESS LLC
Entity Type:Organization
Organization Name:TENSEGRITY PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:GAITHER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:520-243-0518
Mailing Address - Street 1:1390 E PLACITA MAPACHE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-3929
Mailing Address - Country:US
Mailing Address - Phone:520-243-0518
Mailing Address - Fax:
Practice Address - Street 1:5501 N ORACLE RD STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3850
Practice Address - Country:US
Practice Address - Phone:520-243-0518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy