# AGEWELL PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1407726458
- **Authorized official:** ANU DURGA ANNPOORNA PIDIKITI (CEO)
- **Authorized official phone:** (916) 906-4103

## Contact information

- **Practice address:** 4818 GOLDEN FOOTHILL PKWY UNIT 1, EL DORADO HILLS, CA 95762-9825
- **Practice address phone:** (916) 906-4103
- **Mailing address:** 4818 GOLDEN FOOTHILL PKWY UNIT 1, EL DORADO HILLS, CA 95762-9825
- **Mailing address phone:** (916) 906-4103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 11/06/2025
- **Last updated:** 11/06/2025