Provider Demographics
NPI:1457869968
Name:WELLNESS UNLIMITED PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:WELLNESS UNLIMITED PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:908-451-7278
Mailing Address - Street 1:4 MATTHEW LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-3254
Mailing Address - Country:US
Mailing Address - Phone:908-451-7278
Mailing Address - Fax:
Practice Address - Street 1:7 CABOT PL
Practice Address - Street 2:3RD FLOOR SUITE A
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-4631
Practice Address - Country:US
Practice Address - Phone:508-851-9809
Practice Address - Fax:888-781-9593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20118261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy