Provider Demographics
NPI:1922882331
Name:QLIFE PHYSICAL THERAPY AND WELLNESS, INC
Entity Type:Organization
Organization Name:QLIFE PHYSICAL THERAPY AND WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DOELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-304-0886
Mailing Address - Street 1:265 SANTA HELENA STE 110
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1538
Mailing Address - Country:US
Mailing Address - Phone:858-304-0886
Mailing Address - Fax:858-210-6372
Practice Address - Street 1:265 SANTA HELENA STE 110
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1538
Practice Address - Country:US
Practice Address - Phone:858-304-0886
Practice Address - Fax:858-210-6372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy