Provider Demographics
NPI:1104598648
Name:RESILIENCE PHYSICAL THERAPY & WELLNESS LLC
Entity type:Organization
Organization Name:RESILIENCE PHYSICAL THERAPY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:S
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:912-656-5936
Mailing Address - Street 1:124 BROMPTON RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-3183
Mailing Address - Country:US
Mailing Address - Phone:912-656-5936
Mailing Address - Fax:
Practice Address - Street 1:150 THUNDERBIRD DR # 307B
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3892
Practice Address - Country:US
Practice Address - Phone:912-656-5936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-04
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy