MTC WELLNESS, LLC


Address: 280 Ripka St, Philadelphia, PA 19127-1125
Phone: 2675717615

MTC WELLNESS, LLC (NPI# 1720641491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720641491
Entity Type Organization
Organization Name MTC WELLNESS, LLC
Practice Address 280 Ripka St
Philadelphia
PA 19127-1125
Practice Telephone 2675717615
Mailing Telephone 2675717615
Enumeration Date 2019-04-18
Last Update Date 2020-09-03
Authorized Official Name MARGARET COLEMAN (OWNER)
Authorized Official Telephone 2675717615
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
1015 Chestnut St Ste 403, Philadelphia, PA 191074304 2157322306

Office Location

Street Address 280 RIPKA ST
City PHILADELPHIA
State PA
Zip Code 19127-1125

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1477197218 Karen M Johnson Social Worker 4001 Main Street, Suite 202, Philadelphia, PA 19127 2019-11-05
1801363304 Associates for Well-being Psychologist 4001 Main Street, Suite 202, Philadelphia, PA 19127 2018-11-01
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1275062549 Jamie Mae Cunningham Specialist/Technologist 153 East Street, Philadelphia, PA 19127 2017-06-08
1073957957 Sarah Alice Sall Massage Therapist 4600 Smick Street, Philadelphia, PA 19127 2013-04-23
1710245303 Marie C Croghan Occupational Therapist 4601 Flat Rock Road, Apt. 514, Philadelphia, PA 19127 2012-05-02
1396938288 Lisa Erin Starke Occupational Therapist 169 Conarroe St, Philadelphia, PA 19127 2007-08-23
1700448511 Stefan Markovic Family Medicine 10 Shurs Ln, #203, Philadelphia, PA 19127 2019-07-01
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1962015537 Joanna Elizabeth Vanore Social Worker 4725 Sheldon St, Philadelphia, PA 19127-1008 2020-08-24
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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Competitor

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City PHILADELPHIA
Zip Code 19127

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Dataset Information

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.

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