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Organization
GREEN WELLS EECP PHYSICAL THERAPY
Active
Organization
GREEN WELLS EECP PHYSICAL THERAPY
Active
Other names
green wells eecp
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARED JASON WELLS (OWNER/CHIEF TECHICIAN)
(310) 405-1478
Entity
Organization
Contact information
Practice address
8602 ELBURG STREET APT C, PARAMOUNT, CA 90723
(310) 405-1478
Mailing address
8602 ELBURG ST UNIT C, 7136 PACIFIC BLVD SUITE 220, PARAMOUNT, CA 90723-8632
(323) 588-5467
(323) 589-6662
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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