Provider Demographics
NPI:1063150084
Name:FEEL GREAT PHYSICAL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:FEEL GREAT PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:LABARRE
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:570-423-9209
Mailing Address - Street 1:3838 JACKSON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WARREN CENTER
Mailing Address - State:PA
Mailing Address - Zip Code:18851-7983
Mailing Address - Country:US
Mailing Address - Phone:570-423-9209
Mailing Address - Fax:
Practice Address - Street 1:3838 JACKSON VALLEY RD
Practice Address - Street 2:
Practice Address - City:WARREN CENTER
Practice Address - State:PA
Practice Address - Zip Code:18851-7983
Practice Address - Country:US
Practice Address - Phone:570-423-9209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy