Provider Demographics
NPI:1851176655
Name:PURE PELVIC WELLNESS
Entity Type:Organization
Organization Name:PURE PELVIC WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:908-930-8877
Mailing Address - Street 1:2419 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1728
Mailing Address - Country:US
Mailing Address - Phone:908-930-8877
Mailing Address - Fax:
Practice Address - Street 1:555 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-2918
Practice Address - Country:US
Practice Address - Phone:908-930-8877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty