Provider Demographics
NPI:1336732684
Name:WELLNESS 360 PHYSICAL THERAPY AND MASSAGE PLLC
Entity Type:Organization
Organization Name:WELLNESS 360 PHYSICAL THERAPY AND MASSAGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:585-469-0201
Mailing Address - Street 1:134 PENARROW RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1724
Mailing Address - Country:US
Mailing Address - Phone:585-469-0201
Mailing Address - Fax:
Practice Address - Street 1:191 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2700
Practice Address - Country:US
Practice Address - Phone:585-259-0782
Practice Address - Fax:585-512-8372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty