Provider Demographics
NPI:1124780036
Name:ZOLL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:ZOLL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:ZOLL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CBIS, MSPT
Authorized Official - Phone:817-880-5701
Mailing Address - Street 1:4716 TEAROSE TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-1817
Mailing Address - Country:US
Mailing Address - Phone:817-880-5701
Mailing Address - Fax:
Practice Address - Street 1:4716 TEAROSE TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-1817
Practice Address - Country:US
Practice Address - Phone:817-880-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy