Provider Demographics
NPI:1558032391
Name:EMPOWERED PHYSICAL THERAPY & WELLNESS, LLC
Entity type:Organization
Organization Name:EMPOWERED PHYSICAL THERAPY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SINGLE MEMBER LLC
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:KARIN
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:703-399-4883
Mailing Address - Street 1:8971 TAWES ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2604
Mailing Address - Country:US
Mailing Address - Phone:240-360-1781
Mailing Address - Fax:240-306-1401
Practice Address - Street 1:8971 TAWES ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2604
Practice Address - Country:US
Practice Address - Phone:240-360-1781
Practice Address - Fax:240-306-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty