Provider Demographics
NPI:1053152553
Name:WONDERFULLY MADE WOMEN'S HEALTH PHYSICAL THERAPY & WELLNESS, LLC
Entity type:Organization
Organization Name:WONDERFULLY MADE WOMEN'S HEALTH PHYSICAL THERAPY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:BURY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:432-853-8530
Mailing Address - Street 1:8210 LALLAROOK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2493
Mailing Address - Country:US
Mailing Address - Phone:432-853-8530
Mailing Address - Fax:
Practice Address - Street 1:8210 LALLAROOK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-2493
Practice Address - Country:US
Practice Address - Phone:432-853-8530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty