Provider Demographics
NPI:1205675246
Name:CAREWELL PHYSICAL THERAPY & BALANCE CENTER LLC
Entity type:Organization
Organization Name:CAREWELL PHYSICAL THERAPY & BALANCE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MANIJOT
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-468-8171
Mailing Address - Street 1:5158 BALLANTRAE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-3065
Mailing Address - Country:US
Mailing Address - Phone:813-468-8171
Mailing Address - Fax:
Practice Address - Street 1:3802 EHRLICH RD STE 309
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2355
Practice Address - Country:US
Practice Address - Phone:813-468-8171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty