Organization
GREEN WELLS EECP PHYSICAL THERAPY
Active
Other names
green wells eecp
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARED JASON WELLS (OWNER/CHIEF TECHICIAN)
(310) 405-1478
Entity
Organization
Contact information
Practice address
8602 ELBURG STREET APT C, PARAMOUNT, CA 90723
(310) 405-1478
Mailing address
8602 ELBURG ST UNIT C, 7136 PACIFIC BLVD SUITE 220, PARAMOUNT, CA 90723-8632
(323) 588-5467
(323) 589-6662
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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