# MAX WELL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MAX WELL THERAPY LLC
- **Other names:** Max Well Physical therapy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1881647337
- **Legal business name:** MAX WELL THERAPY LLC
- **Authorized official:** JILL M MAXWELL PT (OWNER)
- **Authorized official phone:** (952) 440-5906

## Contact information

- **Practice address:** 14033 COMMERCE AVE NE, PRIOR LAKE, MN 55372-1438
- **Practice address phone:** (952) 440-5906
- **Practice address fax:** (952) 440-5907
- **Mailing address:** 14033 COMMERCE AVE NE, PRIOR LAKE, MN 55372-1438
- **Mailing address phone:** (952) 440-5906
- **Mailing address fax:** (952) 440-5907

## Taxonomy

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

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 09/13/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 018K0MA | GROUP \# | MN |
| 01 | — | 1819187 | AMERICAS PPO | MN |
| 01 | — | AETNA | 7368023 | MN |