Provider Demographics
NPI:1740714310
Name:NEW SEASONS PHYSICAL THERAPY AND WELLNESS, PLC
Entity type:Organization
Organization Name:NEW SEASONS PHYSICAL THERAPY AND WELLNESS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:989-330-0396
Mailing Address - Street 1:422 STUART AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3220
Mailing Address - Country:US
Mailing Address - Phone:989-330-0396
Mailing Address - Fax:
Practice Address - Street 1:810 W KILGORE RD STE 6
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3601
Practice Address - Country:US
Practice Address - Phone:269-366-0046
Practice Address - Fax:269-220-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy