# WELLNESS ON WHEELS PHYSICAL THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396416616
- **Authorized official:** KELLY LYNN SHANNON DPT (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (240) 447-5226

## Contact information

- **Practice address:** 933 COCHRAN ST, DANIEL ISLAND, SC 29492-7577
- **Practice address phone:** (240) 447-5226
- **Mailing address:** 933 COCHRAN ST, DANIEL ISLAND, SC 29492-7577
- **Mailing address phone:** (240) 447-5226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2021
- **Last updated:** 09/27/2021