Provider Demographics
NPI:1063078392
Name:WELL BEINGS THERAPIES LLC
Entity type:Organization
Organization Name:WELL BEINGS THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, ATHLETIC TRAINER
Authorized Official - Prefix:
Authorized Official - First Name:MARIKA
Authorized Official - Middle Name:P
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:978-430-0316
Mailing Address - Street 1:225 MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:WENHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01984-1459
Mailing Address - Country:US
Mailing Address - Phone:978-468-6300
Mailing Address - Fax:978-468-6300
Practice Address - Street 1:225 MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:WENHAM
Practice Address - State:MA
Practice Address - Zip Code:01984-1459
Practice Address - Country:US
Practice Address - Phone:978-468-6300
Practice Address - Fax:978-468-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1013373828OtherNPPES
MA1255324570OtherNPPES