Provider Demographics
NPI:1275321556
Name:JEWEL PHYSICAL THERAPY AND WELLNESS, INC
Entity type:Organization
Organization Name:JEWEL PHYSICAL THERAPY AND WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:KNIGHTLY
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:413-281-4305
Mailing Address - Street 1:4960 ROSEHEDGE DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-9519
Mailing Address - Country:US
Mailing Address - Phone:980-785-3935
Mailing Address - Fax:
Practice Address - Street 1:4960 ROSEHEDGE DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-9519
Practice Address - Country:US
Practice Address - Phone:980-785-3935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy