Organization
WELLNESS INTERPROFESSIONAL PHYSICAL THERAPY CORPORATION, PC
Active
Other names
MetroHealth Station, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE JOSEPHINE SULLIVAN P.T. (CEO/PRESIDENT)
(323) 730-1205
Entity
Organization
Contact information
Practice address
3501 W JEFFERSON BLVD, LOS ANGELES, CA 90018-3237
(323) 730-1205
(213) 221-4778
Mailing address
3501 W JEFFERSON BLVD, LOS ANGELES, CA 90018-3237
(323) 730-1205
(213) 221-4778
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
53973
CA
106H00000X
Marriage & Family Therapist
80856
CA
1223G0001X
General Practice Dentistry
44450
CA
1223G0001X
General Practice Dentistry
63162
CA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
87429
CA
2251G0304X
Geriatric Physical Therapist
15587
CA
2251N0400X
Neurology Physical Therapist
14280
CA
2251P0200X
Pediatric Physical Therapist
40379
CA
261QM1300X
Multi-Specialty Clinic/Center
Primary
14280
CA
364SA2200X
Adult Health Clinical Nurse Specialist
22533
CA
Other
Enumeration date
07/02/2014
Last updated
05/18/2016
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