Provider Demographics
NPI:1588716765
Name:WOMENS THERAPY AND WELLNESS COMPANY
Entity type:Organization
Organization Name:WOMENS THERAPY AND WELLNESS COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PTA OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MITZI
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:334-673-7282
Mailing Address - Street 1:407 N SHADY LN
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2946
Mailing Address - Country:US
Mailing Address - Phone:334-673-7282
Mailing Address - Fax:334-673-7283
Practice Address - Street 1:407 N SHADY LN
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2946
Practice Address - Country:US
Practice Address - Phone:334-673-7282
Practice Address - Fax:334-673-7283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51503542OtherBCBS PROVIDER NUMBER