# MAXIMUM HEALTH & WELLNESS GLENDALE, LLC

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

## Provider details

- **NPI number:** 1467851105
- **Authorized official:** JENNIFER R CARROLL (OFFICE REP)
- **Authorized official phone:** (352) 942-1204

## Contact information

- **Practice address:** 6545 OTTO RD, GLENDALE, NY 11385-6204
- **Practice address phone:** (718) 417-7500
- **Practice address fax:** (718) 417-7501
- **Mailing address:** 6545 OTTO RD, GLENDALE, NY 11385-6204
- **Mailing address phone:** (718) 417-7500
- **Mailing address fax:** (718) 417-7501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | Yes |
| 111N00000X | Chiropractor | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 08/19/2014
- **Last updated:** 08/19/2014