Provider Demographics
NPI:1528857521
Name:ENRICH PHYSICAL THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:ENRICH PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SURYANARAYANA
Authorized Official - Middle Name:RAJU
Authorized Official - Last Name:KALIDINDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-431-9949
Mailing Address - Street 1:26003 PARTY SLIPPERS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-3436
Mailing Address - Country:US
Mailing Address - Phone:814-431-9949
Mailing Address - Fax:
Practice Address - Street 1:9542 WITTEN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2179
Practice Address - Country:US
Practice Address - Phone:989-600-4142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty