Provider Demographics
NPI:1487363040
Name:SAVANNAH PELVIC HEALTH AND WELLNESS, LLC.
Entity type:Organization
Organization Name:SAVANNAH PELVIC HEALTH AND WELLNESS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:POLK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:912-503-0516
Mailing Address - Street 1:209 THATCHER ST
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-5842
Mailing Address - Country:US
Mailing Address - Phone:912-503-0516
Mailing Address - Fax:
Practice Address - Street 1:408 US HIGHWAY 80 SW
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-2541
Practice Address - Country:US
Practice Address - Phone:912-503-0516
Practice Address - Fax:912-600-1994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty