Provider Demographics
NPI:1285176644
Name:VELOCITY PHYSICAL THERAPY & WELLNESS CLINIC, LLC
Entity type:Organization
Organization Name:VELOCITY PHYSICAL THERAPY & WELLNESS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG-SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:715-505-3030
Mailing Address - Street 1:916 CARMICHAEL RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-8280
Mailing Address - Country:US
Mailing Address - Phone:715-716-5191
Mailing Address - Fax:715-716-5190
Practice Address - Street 1:916 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-8280
Practice Address - Country:US
Practice Address - Phone:715-716-5191
Practice Address - Fax:715-716-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11309-24261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy