Provider Demographics
NPI:1982807574
Name:DOWNEY WELLNESS PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:DOWNEY WELLNESS PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLEGRA
Authorized Official - Middle Name:ANN DANNA
Authorized Official - Last Name:DEMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:310-373-9721
Mailing Address - Street 1:11411 BROOKSHIRE AVE
Mailing Address - Street 2:#504
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5003
Mailing Address - Country:US
Mailing Address - Phone:310-373-9721
Mailing Address - Fax:
Practice Address - Street 1:11411 BROOKSHIRE AVE
Practice Address - Street 2:#504
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5003
Practice Address - Country:US
Practice Address - Phone:310-373-9721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty