# ADVANCED WELLNESS LOUISIANA LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1861919060
- **Authorized official:** MR. KRISTOPHER WILLIAM GRUNEWALD DPT (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (225) 202-6124

## Contact information

- **Practice address:** 9808 BLUEBONNET BLVD STE 201, BATON ROUGE, LA 70810-6442
- **Practice address phone:** (225) 202-6124
- **Mailing address:** 2023 N WOODCHASE CT, BATON ROUGE, LA 70808-4023
- **Mailing address phone:** (225) 202-6124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 07612 | LA | Yes |

## Other

- **Enumeration date:** 08/28/2017
- **Last updated:** 09/08/2017