Provider Demographics
NPI:1760729032
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:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUHARTH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-921-9000
Mailing Address - Street 1:2525 S. RURAL ROAD
Mailing Address - Street 2:SUITE 5-S
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282
Mailing Address - Country:US
Mailing Address - Phone:480-921-9000
Mailing Address - Fax:
Practice Address - Street 1:2525 S. RURAL ROAD
Practice Address - Street 2:SUITE 5-S
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282
Practice Address - Country:US
Practice Address - Phone:480-921-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43982251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty