Provider Demographics
NPI:1003607003
Name:MOBILE WELLNESS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:MOBILE WELLNESS PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:317-910-6774
Mailing Address - Street 1:3555 THOMAS JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-7558
Mailing Address - Country:US
Mailing Address - Phone:317-910-6774
Mailing Address - Fax:
Practice Address - Street 1:3555 THOMAS JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-7558
Practice Address - Country:US
Practice Address - Phone:317-910-6774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-16
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty