Provider Demographics
NPI:1942890793
Name:5 ELEMENTS PELVIC HEALTH AND WOMENS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:5 ELEMENTS PELVIC HEALTH AND WOMENS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-382-2655
Mailing Address - Street 1:184 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MORRO BAY
Mailing Address - State:CA
Mailing Address - Zip Code:93442-2750
Mailing Address - Country:US
Mailing Address - Phone:808-382-2655
Mailing Address - Fax:
Practice Address - Street 1:184 MAIN ST
Practice Address - Street 2:
Practice Address - City:MORRO BAY
Practice Address - State:CA
Practice Address - Zip Code:93442-2750
Practice Address - Country:US
Practice Address - Phone:808-382-2655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy