NEUROLOGIC OPTIMAL WELLNESS PHYSICAL THERAPY LLC (NPI# 1538786272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538786272 |
| Entity Type | Organization |
| Organization Name | NEUROLOGIC OPTIMAL WELLNESS PHYSICAL THERAPY LLC |
| Practice Address |
180 King St Springfield MA 01109-4316 |
| Mailing Address |
914 State St Unit 91404 Springfield MA 01139-7758 |
| Practice Telephone | 4132627066 |
| Mailing Telephone | 4132627066 |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | KATRINA JENETTA BANKS (OWNER/PHYSICAL THERAPIST) |
| Authorized Official Telephone | 4132627066 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
180 KING ST |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01109-4316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720479892 | Ethan Chase | Dentist | 555 State Street, Dental Dreams, Springfield, MA 01109 | 2015-02-11 |
| 1043591423 | Victoria A Jones | Counselor | 1104 Street Street, Suite 2d, Springfield, MA 01109 | 2011-08-30 |
| 1093043879 | Lee Ann Callagher | Occupational Therapist | 807 Wilbraham Rd., Springfield, MA 01109 | 2009-12-07 |
| 1740424993 | Pamela Joan Aselton | Nurse Practitioner | 263 Alden Street, Springfield College Health Service, Springfield, MA 01109 | 2009-04-30 |
| 1225642507 | Emma V Slater | Student in an Organized Health Care Education/Training Program | 263 Alden St, Springfield, MA 01109 | 2020-09-03 |
| 1184253239 | Hye Young Shin | Dentist | 555 State St, Springfield, MA 01109 | 2020-04-01 |
| 1225662992 | Mary Catherine Becker | Student in an Organized Health Care Education/Training Program | 263 Alden Street, Springfield, MA 01109 | 2020-03-02 |
| 1235630856 | Kathryn O'brien | Student in an Organized Health Care Education/Training Program | 11 Wilbraham Rd, Springfield, MA 01109 | 2018-02-28 |
| 1174074736 | Candace Griffith | Counselor | 140 High St., Suite 230, Springfield, MA 01109 | 2016-10-19 |
| 1356730279 | Pedro Ferrer | Counselor | 332 Birnie Ave, Springfield, MA 01109 | 2015-01-15 |
| Find all providers in zip 01109 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
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| 1154948933 | My Pt and Pilates Inc | Clinic/Center | 6706 Red Jacket Rd, Springfield, VA 22152-2633 | 2020-06-29 |
| 1043836588 | Martin Ventures LLC | Clinic/Center | 3119 S Scenic Ave Ste B, Springfield, MO 65807-3965 | 2020-06-21 |
| 1871129338 | Five Star Rehabilitation and Wellness Services LLC | Clinic/Center | 900 E Southwind Rd, Springfield, IL 62703-5369 | 2020-03-17 |
| 1992262554 | Agilitas Usa, Inc | Clinic/Center | 3556 Tom Austin Hwy Ste 2, Springfield, TN 37172-3960 | 2019-03-01 |
| 1336656461 | Back and Body Pain Relief LLC | Clinic/Center | 355 Route 22 Ste D, Springfield, NJ 07081-3511 | 2018-01-10 |
| 1699142828 | Alissa Slater | Clinic/Center | 7912 Journey Ln, Springfield, VA 22153-2725 | 2015-08-24 |
| 1801189121 | Physiotherapy Associates Inc | Clinic/Center | 1739 Allen St, Springfield, MA 01118-1805 | 2011-05-19 |
| 1912208414 | Flexeon Rehabilitation Springfield Ohio, LLC | Clinic/Center | 1303 West 1st Street, Springfield, OH 45504 | 2010-11-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01109 |
Please comment or provide details below to improve the information on NEUROLOGIC OPTIMAL WELLNESS PHYSICAL THERAPY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.